The challenges of reliability and safety – an exploration of strategies that can lead to higher reliability

Dr Stephen Walker

Everyone comes to work to do their best, and yet we know that despite knowing what needs to be done and how to do it, we do not always deliver the care we planned. Having the right knowledge and technical skills to do our work is important, yet there is a need for more work to be done to make our workplaces more reliable and safe for our clients and patients. High reliability organisations find the right balance of safe processes and systems as well as being mindful of human factors that can impact on the people that work in those systems. Some variance in the care we deliver to patients is warranted because our experience and knowledge tell us standard care needs to be modified to best suit a particular setting or patient need. Unfortunately, we have a good amount of variance in the care we deliver that is not in patients’ best interests as we simply fail to deliver what we decided they needed.  During this presentation we will consider what might be behind unwanted variance and explore some strategies that could be useful to control it. An understanding of human factors can give us insights into reliability and safety and some well-chosen checking strategies introduced in our practice can have a strong influence on local culture and have been shown to deliver improvements. Many of these same strategies work well in other parts of our lives outside our clinical roles.



Dr Stephen Walker is the Associate Medical Director of Cognitive Institute. Prior to joining Cognitive Institute Dr Walker held the positions of Director of Clinical Training, Deputy Director of Medical Management and Emergency Physician at Mater Health Services Brisbane.

His previous appointments have included Deputy Director of Emergency Medicine at Mater Hospital, Deputy Director and Director of the Emergency Department at Ballarat Health Services and Emergency Department Director at St John of God Hospital Ballarat.

Dr Walker also serves the Committee of Management for Emergency Life Support Inc, a not-for-profit education and training group providing emergency education and skills training throughout Australia and parts of Asia Pacific. He previously held the position of Senior Lecturer in the Department of Anaesthesia and Critical Care, University of Queensland. He has served on the Primary Examination Committee and Fellowship Examination Committees of the Australian College for Emergency Medicine.

Dr Walker has special interests in education and process improvement in clinical settings. He has published on trauma care efficacy and patient communication. He is currently completing a Master of Health Management at the University of New South Wales.

In 2013 Dr Walker was named 2013 Queensland Clinical Educator of the Year. In 2004 he was the recipient of the Mater Health Services Excellence in Clinical Teaching Award.