High-Reliability Organizations and Patient Safety

High-Reliability Organizations and Patient Safety

High-reliability organizations were mainly developed to address incidences of serious accidents or catastrophic failures. In the health care sector, however, the institutions are more suitable due to the risks and complexities of operations or consequences which may occur during a medical procedure. Additionally, HROs are regarded as the most effective standardization process because they cultivate resilience through relentless prioritization of safety rather than pressuring facilities to keep up high performance (Mountasser Kadrie, 2017). Therefore, they are characterized by systematic thinking approaches during safety evaluations and design. This is following their nature which considers protecting an emergent determinant rather than a static one. For instance, there are different risk factors that constantly threaten the safety of individuals or facilities and, hence, one can neither be certain about an incidence nor can he/she come across two accidents which are the same. Thus, HROs create an environment where challenges are expected, which makes the preparation process much faster such that the problems are detected at an early stage. In return, positive responses are initiated which ultimately prevents any catastrophic consequences.

Nevertheless, the existence of High-Reliability Organizations in the healthcare industry has not been off to a good start as there are a variety of challenges that inhibit their success. This is primarily because despite having serious and widespread determination to enhance quality in the medical sector, most facilities find it difficult to sustain improvements. As a result, thousands of patients have continued to suffer from preventable repercussions daily. Conversely, institutions have been encountering project fatigue in the middle of an approach to resolve specific problems in the administration or the practical environment which might be demeaning safety. For instance, in America, no hospital has proven its ability or willingness to achieve excellence throughout its departments consistently.

Even so, the integration of High-Reliability Organizations into the medical sector has borne certain benefits to the facilities and patients. Firstly, HROs operate on a concept of preoccupation with failure and, hence, this keeps hospitals on the alert of any challenge that may emerge or compromise its goals and visions (Desai, Madsen, & Roberts, 2016). As a result, most institutions have incorporated a business theory into their strategic planning ideas to make sure that they prioritize what is important rather than focusing on employee’s performance. Secondly, HROs are sensitive to operations which means that they are always striving to attain a steady level of awareness for any working conditions. This has forced the federal government and non-governmental foundations to facilitate medical centers in running programs that enhance the knowledge of practitioners as well as the patients. In return, subjects have been receiving better treatment and care while the level of quality and safety is well-maintained (Chassin, & Loeb, 2013). On the other hand, HROs are reluctant to simplicity since they operate on complex structures. Thus, they steer innovations and improvement in this sector so that hospitals can keep up with the pace and requests of their clients.

Nonetheless, the application of the HROs in this sector has the sole goal to improve quality and safety in medical institutions. This is by focusing on activities that will enable hospitals to attain the best results in all areas and, hence, making them dependable. According to research, however, HROs have not been able to accomplish much in the health care industry since their strategies are not directly applicable to most of the facilities today (Desai et al., 2016) Nevertheless, there are specific changes which could be administered to ensure that every medical center is compatible with the HRO structure. For instance, hospitals could consider altering their leadership perspective from a hierarchy that is based on more authoritative people. Instead, the administration should create a common ground so that everyone can strive to learn more about safety and quality. On the other hand, professionals should not be appreciated due to their abilities to resolve problems in the absence of any help but preferably for participating in the least way possible so long as they are contributing to highly reliable goals. Still, patients should make it easy for practitioners to do their jobs while other stakeholders provide all the support needed to ensure that the project is successful.

Similarly, High-Reliability Organizations are developed in such a way that they are deference to expertise. This means that they appreciate professionals who work in close relations with them in a quest to achieve quality and safety. Therefore, their integration into the healthcare industry has fostered improvement in interpersonal relations and the working environment by stripping away superiority based on the level of education or experience. Rather, everyone who has been a part of the process is recognized and, hence, promoting a spirit of inquiry and learning in all teams. According to a study by Mountasser Kadrie (2017), for example, medical centers which had implemented suggestions based on HROs have achieved results that foster their effectiveness. Additionally, it has become easy to attain consumer satisfaction as well as improved compliance, efficiency, documentation, and corporate culture. On the other hand, hospitals have experienced performance excellence and accountability in their areas of concern. Therefore, the interest of the payer in an HRO is to obtain these benefits without having to go through a system that is more concerned about monetary returns rather than the safety of the patient.




Chassin, M. R., & Loeb, J. M. (2013). High‐reliability health care: getting there from here. The Milbank Quarterly91(3), 459-490.

Desai, V., Madsen, P. M., & Roberts, K. H. (2016). High-reliability organizations in health care. In Handbook of Human Factors and Ergonomics in Health Care and Patient Safety(pp. 200-211). CRC Press.

High Reliability | AHRQ Patient Safety Network. (2019). Retrieved from https://psnet.ahrq.gov/primers/primer/31/High-Reliability

Jacobson, G. (2019). 5 Principles of a High Reliability Organization (HRO). Retrieved from https://blog.kainexus.com/improvement-disciplines/hro/5-principles

Mountasser Kadrie, D. (2017). High Reliability Organization in the Healthcare Industry: A Model of Performance Excellence and Innovation.