Describe the elements necessary to create a high-reliability organization (HRO). How are HROs related to safety and quality? What approach can the nurse administrator use to develop the necessary elements in an organization?
A high-reliability organization (HRO) is an entity that operates in high-risk environments and consistently achieves safety, quality, and efficiency goals, despite the inherent risks. Creating an HRO requires the following elements:
- Preoccupation with Failure: This involves a constant focus on identifying and mitigating potential failures before they happen.
- Sensitivity to Operations: HROs have a keen awareness of their day-to-day operations and are responsive to changes in their environment.
- Reluctance to Simplify: HROs recognize that complex systems require complex solutions and resist the temptation to oversimplify.
- Resilience: HROs have the ability to bounce back from adverse events and to adapt quickly to changing circumstances.
- Deference to Expertise: HROs place a high value on the knowledge and expertise of their employees and encourage a culture of learning and continuous improvement.
- Commitment to Safety: Safety is the overriding priority for HROs, and all decisions are made with the goal of ensuring the safety of employees and patients.
HROs are closely related to safety and quality because they are designed to operate in high-risk environments where safety and quality are paramount. HROs achieve exceptional safety and quality outcomes by creating a culture of continuous improvement and by implementing systems and processes that reduce the likelihood of errors and adverse events.
Nurse administrators can use the following approach to develop the necessary elements of an HRO:
- Identify the key risks: Nurse administrators should conduct a thorough risk assessment to identify the potential risks in their organization.
- Create a culture of safety: Nurse administrators should promote a culture of safety by encouraging open communication, reporting of errors and adverse events, and by providing regular safety training.
- Invest in technology and processes: Nurse administrators should invest in technology and processes that enhance safety and quality, such as electronic health records, automated medication dispensing systems, and error prevention tools.
- Empower employees: Nurse administrators should empower employees by providing them with the necessary resources and training to make informed decisions and to contribute to the continuous improvement of the organization.
- Measure and monitor performance: Nurse administrators should establish performance metrics and regularly monitor and report on safety and quality outcomes to identify areas for improvement.
By implementing these strategies, nurse administrators can create a culture of safety and quality that is essential for developing an HRO