High Reliability Organizations

High Reliability Organizations




The concept of HROs

High reliability organizations are organizations that have had a success in reducing or avoiding catastrophes in any business environment where accidents are prone to occur. They mainly operate in domains where hazards are expected. They are characterized by the use of system thinking in order to examine and design safety precautions. Here, they expect and know that there are many uncertainties and no two accidents can be alike. Therefore, high reliability organizations aim to create a domain in which obvious problems are most anticipated, noticed earlier and respond to it immediately to reduce catastrophic outcomes (Schulman, 2012). This system of thinking is featured by five principles: preoccupation with no success, acting slowly to simplify explanations for operations, success and failures, being sensitive in operations and finally total commitment to resilience.

How HROs can transform Healthcare

The concept of high reliability is necessary for healthcare. Healthcare operations seem very complex and risky which can lead to various catastrophes and hence there is the need to adopt some means to reduce such. High reliability in healthcare can best be termed as a situation of persistent mindfulness within the healthcare. HROs can transform healthcare by cultivating resilience by giving safety a first priority over other performances within the organization (In Fottler, In Malvey, & In Slovensky, 2015). By healthcare becoming highly reliable, it will need the effort of all workers within the organization. Firstly, the workers will have to look for and report any problem or unsafe situation before causing a greater risk to the organization while they can be easily fixed.

By so doing, they will reduce all forms of accidents. The workforce identifies the common errors and meets together so that they can perform a careful analysis of what has been happening before these events. This study will therefore point to specific weaknesses in safety measures or design ways that can reduce the risk of the future events. The earlier named principles of this system if taken carefully into consideration will enable the healthcare maintain extraordinary level of safety. The first principle on preoccupancy with failure enables the workforce to be alert to every signal that a new threat to safety is slowly establishing (In Oster, In Braaten, & Sigma Theta Tau International, 2016). Early recognition to these threats makes a greater significance since it’s detected and easily corrected.

The principle on sensitivity to operations enables the workforce to detect early indicators of threats to safety in the healthcare. Hence, they take high considerations and ensure that they always report any problem from operation. It enables all the workers within the healthcare to know that it is their responsibility to report the errors so as to achieve a higher standard of safety. On commitment to resilience, it makes the workforce understand that despite the many efforts and successes they have achieved on safety, threats are prone to occur at any given time (Kimbell, 2014). Therefore, they will detect the errors early enough and keep them in mind therefore prevent the harm that could be caused by the errors.

Why little progress has been made in healthcare towards becoming an HRO

To begin with, changing and responding to the surroundings of the healthcare is a reason to slow progress in adopting the high reliability system. Healthcare operates both with external and internal environment which is characterized by several factors. The external environment which majorly entails government regulations, patient population and competition from other hospitals may lead to slow adoption of the system. Hospitals leaders clearly understand these factors and incase of any barrier they are the ones to address them effectively. Joining hands together with the community to solve these barriers can be hard and therefore makes it hard to attain the high reliability system (In Oster, In Braaten, & Sigma Theta Tau International, 2016). It takes a lot of time to engage them hence resulting to some failures.

On internal environment, there are some factors that contribute to its operations. Executive leaders, human resource policies and finance can contribute to failure of the system. Executive leaders can fail to offer support on means of detecting threats to safety and therefore becomes a go slow thing in attaining high reliability. Getting the Chief Financial Officer to be convinced to offer some aid in safety management is so critical. It takes a good time to get to him or her and therefore it ends up delaying the adoption of the high reliability system.

Moreover, planning and implementations of improvement initiatives is a key factor to delay in healthcare becoming HRO. Most of the initiatives at the organization may be excellent but fail due to poor approach in its design implementation (In Oster, In Braaten, & Sigma Theta Tau International, 2016). If the health organization management does not understand the pressure and the challenges the people are facing, definitely implementing the initiatives will terribly fail. They have to collect all the information from the people and see those challenges in real life and therefore implement the corrective measures necessary.

Improvements that can be adopted by healthcare towards becoming HROs

First of all healthcare organization has to be more transparent. Here the leaders need to give more organizational awareness by improving communication process and the process of sharing data to their employees and also the patients. To add on this, they don’t have to make any assumptions regarding to the organization’s operations (Nguemaleu, & Montheu, 2014). They have to know and ask questions about the processes that are taking place. They can get this from the staff. Secondly, in the process of examining data and metrics, they must be willing to challenge some beliefs. When they meet, the leaders look at these data and metrics and therefore they should seek more information that challenges them currently and know why challenges exists all these to prevent simplification.

Furthermore, the leaders and the stakeholders should identify the correctly working processes. By doing this, they will take up the necessary correction needed when an implementation is achieved incorrectly. They will do this by finding another place within the organization in which such processes are run effectively. They should focus on enabling the employees notice that success can be achieved by borrowing better operations from other operations that have succeeded. Finally, the stakeholders should use better tools for evaluation so as to maintain high reliability within the healthcare (Kimbell, 2014). They should majorly emphasize on good skill development among their employees and this will help tackle the challenges and establish new ways on solving safety threats.

Potential interest of the payer in an HRO

The potential interest of the payer in an HRO is to realize that the organization has achieved free catastrophe situations among different environments. They form a basis for employees and individuals to interact and share the problems they encounter in their organizations while establishing the means for correction precautions. Their main interest is to realize that the organizations practices and processes contribute to safety and reduction of any complex and risky situations within the organization (Schulman, 2012). The payers’ interest is to fancy good safety practices against all forms of possible catastrophes in their environment.


In Fottler, M. D., In Malvey, D. M., & In Slovensky, D. J. (2015). Handbook of healthcare management.

In Oster, C., In Braaten, J., & Sigma Theta Tau International. (2016). High reliability organizations: A healthcare handbook for patient safety & quality.

Kimbell, L. (2014). The service innovation handbook: Action-oriented creative thinking toolkit for service organizations : templates – cases – capabilities.

Nguemaleu, R. -A., & Montheu, L. (2014). Roadmap to greener computing.

Schulman, P. R. (2012). Managing high reliability organizations (HROs): Insights from HRO operations. London: Henry Stewart Talks.

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