High Reliability in Health Care.

Gill, Amrit; Leiner, C Derek; Steinberg, Daniel I · Med Clin North Am · 2025

other · Level V

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Abstract

High reliability organizations (HROs) experience miniscule accident rates despite their complexity. HROs share 5 core principles: preoccupation with failure, sensitivity to operations, reluctance to simplify, deference to expertise, and commitment to resilience. These cultural principles must coincide with a strong culture of psychological safety, process improvement, and continuous learning to achieve zero harm. The health care industry should aim to build high reliability to reduce patient and staff harm. The authors provide case studies of HRO implementations and steps leaders can take to begin the high reliability journey.

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