The University of Virginia Health System (A): Creating a High-Reliability Organization

Tracey Hoke, MD, chief of quality and performance improvement for the University of Virginia Health System (UVAHS), is deciding how to better achieve organizational goals in safety and quality. UVAHS is at a critical junction: It must adapt to changes in the health care industry to sustain itself financially. To do so, it has introduced new C-suite leadership, health system goals, and a new patient safety and quality-improvement program called Be Safe, which includes Lean performance-management tools. Now, Hoke must define next steps. This A case examines the transformation of UVAHS into a leader of operational excellence focused on both patient outcomes and health care team members’ well-being with its signature quality-improvement and safety program, Be Safe. The B case allows a deeper dive into hospital reorganization in order to effect change. The case set enables a discussion of operational management and leadership decision points. It provides opportunities for class discussions of managing organizational change, understanding senior leadership in launching and implementing a major operational transformation, and applying Lean principles and methods in health care operations. It also exposes students to issues currently facing the health care industry, particularly from an academic hospital standpoint. At the University of Virginia Darden School of Business, it is taught in the second-year elective, “Solutions and Innovations in Health Care”; it would also be suitable in a module covering Lean management systems. Video of Hoke discussing Be Safe is included in the teaching note.