Midwest Alliance for Patient Safety

High Reliability

High Reliability in Healthcare: Journey to Becoming a Highly Reliable Organization (HRO)

The IHA and our member hospitals have long taken pride in our leadership position on patient safety and quality improvement. Highly Reliable Organizations (HROs) are organizations that manage safety hazards extremely well and do so consistently over extended periods of time. High reliability in healthcare signifies an excellent quality of care is consistently delivered for every patient, every time with a commitment to zero preventable harm. To see a video on Why High Reliability Matters click here.

High Reliability in Healthcare:

  • Improves organizational effectiveness
  • Improves organizational efficiency
  • Improves customer satisfaction
  • Improves compliance
  • Improves organizational culture
  • Improves documentation

The road to high reliability is an ongoing journey. It’s a commitment to patient safety and the way we deliver quality health care. In support of Illinois hospitals transitioning into HROs, IHA partnered with the Joint Commission Center for Transforming Healthcare to provide HRO programming and resource support. As the third state in the U.S. to partner with the Center for Transforming Healthcare on a statewide HRO improvement effort, MHA-IHA Keystone Hospital Engagement Network (HEN) 2.0 hospitals committed to Tier 1 of the HRO journey.

                 Join the Journey to High Reliability the Gold Standard in Healthcare

The IHA/ Center for Transforming Healthcare High Reliability program is a commitment of hospital CEO and senior management teams, including the CMO, CNO, CFO, COO, human resources leader, and quality/patient safety leaders. The Tier 1 commitment consists of completing the Oro™.2.0 High Reliability Organizational Assessment.

About Oro™ 2.0 High Reliability Assessment & Resources:

Oro™ 2.0 is an online organizational assessment with resources designed to guide hospital leadership throughout the high reliability journey, specifically within the areas of:

  • Leadership Commitment
  • Safety Culture
  • Performance Improvement

The discoveries made throughout the Oro™ 2.0 process help organizations identify their high reliability maturity level and opportunities for improvement. A detailed summary report complete with resources help further the organization’s maturity level. To learn more about Oro™ 2.0 click here.

It is important to note while the assessment was created by the Center for Transforming Healthcare, completion of this assessment is separate from Joint Commission accreditation. Surveyors will not have access to your organization-specific data. Hospitals  accredited by The Joint Commission are still eligible to administer the assessment and can gain access by contacting Adam Kohlrus.

As part of our ongoing commitment to high reliability and Illinois Hospitals becoming HROs please review the following recorded webinars, upcoming coaching calls, deadlines and resources:

Recorded Webinars:

  • May 3, 2016 Webinar Recording: Introduction to High Reliability Organizations
    • Presentation slides can be accessed here.
  • May 11, 2016 Webinar Recording: High Reliability Assessment Demonstration
    • Presentation slides can be accessed here.
  • High Reliability Principles I: Webinar Recording  Slides
    • Dr. Erin DuPree, vice president and chief medical officer for the Joint Commission Center for Transforming Healthcare, discusses the five characteristics of High Reliability Organizations.
  • High Reliability Principles II: Webinar Recording  Slides
    • Dr. Danielle Scheurer, chief quality officer for Medical University of South Carolina (MUSC), discusses tactics for achieving High Reliability as well as some of the successes and challenges that they’ve had along their journey.
  • Steps to Success with the Oro™2.0 High Reliability Organizational Assessment: Webinar Recording  Slides
    • “Steps to Success with the Oro™2.0 High Reliability Organizational Assessment” refreshes the audience on the concepts of Leadership commitment to zero patient harm and building trust through transparency. In addition, this webinar guides organizations through recommended steps for creating an action plan following the completion of the Oro™ 2.0 High Reliability Organizational Assessment.
  • Creating a Culture of Safety at Your Organization: Webinar Recording  Slides
    • Dr. Ron Wyatt, Patient Safety Officer and Medical Director at the Joint Commission, discusses the importance of leadership behavior, trust, culture, and critical error reporting and analysis in building a High Reliability Patient Safety System.
  • The High Reliability Journey: Keys to a Successful Robust Process Improvement® Program: Webinar Recording Slides
    • Rob Curry, President and CEO of Citrus Valley Health Partners along with Klaus Nether, Director of Solutions Development at the Joint Commission Center for Transforming Healthcare, will present on building a successful Robust Process Improvement® (RPI®) program. Klaus will cover key aspects of RPI®. Rob will share the story of their journey to high reliability. He will highlight the importance of Leadership and Board commitment, how the RPI® program has supported their journey, how the RPI® program has been sustained, and the benefits and outcomes they’ve achieved from using RPI®.
  • The Just Culture: From Theory to Application: Webinar Recording Slides
    • This webinar first outlines key paradigms that must be embraced when embarking on a just culture journey. Next criterion for organizational responses in the wake of an adverse event are discussed, followed by a review of employee behaviors recognized in a just culture.  A just culture decision support tool is presented and applied to case studies with group interaction.
  • RPI Webinar: Webinar Recording Slides
    • Mark Chassin, MD, FACP, MPP, MPH, President and CEO of The Joint Commission, will be presenting on Robust Process Improvement® (RPI®), a blended approach that includes the tools of Lean, Six Sigma, and formal Change Management. Achieving high reliability in healthcare through RPI methodologies can lead to dramatic improvements in patient care, business operations and financial performance. Dr. Chassin will discuss how these methodologies bring sustainable solutions to the most persistent problems health care organizations currently face.
  • Facilitating Change and the Rocket Science of Improvement: Webinar Recording Slides
    • Healthcare is in the midst of unprecedented change. This session features lessons learned from leaders who brought change management into their organizations and prepare their organizations to seek, commit to and accept change as well as sustain the gains of improvement. Participants will learn the Joint Commission’s change management model, Facilitating Change™, and practical change management tools.
  • Using IT to Improve Patient Safety: Webinar Recording Slides
    • Electronic health records (EHRs) have potential to improve quality and safety of healthcare. However, EHR users have experienced safety concerns from EHR design and usability features that are not optimally adapted for the complex work flow of real-world practice. Few strategies exist to address unintended consequences from implementation of EHRs and other health information technologies.
      It is proposed that organizations equipped with EHRs should consider the strategy of "proactive risk assessment" of their EHR-enabled healthcare system to identify and address EHR-related safety concerns. In this talk, Dean Sittig will describe the conceptual underpinning the EHR-related self-assessment strategy to provide institutions a foundation upon which they could build their safety efforts.
  • Advanced Leadership for Safety: Webinar Recording Slides
    • How safe is your hospital? When board and C-suite leaders answer this question, they most commonly talk about how much harm has, or has not, occurred in the past—rates of healthcare-acquired infections, or numbers of Serious Safety Events, for example. These measures are important, but they are “lagging indicators,” which describe how safe your hospital was yesterday—not how safe you are right now, or how safe you will be tomorrow. Advanced leadership of safety requires answers to 4 “leading indicator” questions developed by Charles Vincent and colleagues at Oxford:
    •        How reliably do you perform key safety processes?
    •        How well do you sense and respond to hour-to-hour operational issues that affect safety?
    •        How well do you anticipate and prepare for future safety risks?
    •        How well do you learn (and integrate the learning) from past safety events?
    •        Does your board ask these questions? Does your C-Suite have thoughtful answers? Join this webinar to learn how you can take your oversight of safety and reliability beyond simple counts of past harm.
  • Improving Collective Mindfulness through “Daily Organizational Huddles”: Webinar Recording Slides                                                                                                                                                                                                                                                                                                                                 AnMed Health CEO William Manson and Director of Performance & Process Improvement Robert Pierce discuss the planning process, structure, and importance of their Daily Organizational Huddle.

HIIN Objectives:

Objective 1: Complete Individual Senior Leadership Oro™ 2.0 High Reliability Organizational Assessment

Access the assessment here. A diagram illustrating steps to complete the Oro™ 2.0 is available here. A sample letter of invitation for CEO communication regarding the assessment is available here.

Objective 2: Complete Group Consensus Oro™2.0 High Reliability Organizational Assessment

A diagram illustrating steps to complete the Oro™ 2.0 is available here.

HRO Resources:

For more information about high reliability in healthcare, what is involved in becoming an HRO, or the MHA/Center for Transforming Healthcare high reliability initiative, contact Adam Kohlrus, Director of Performance Improvement at IHA.

This webpage is intended to act as a resource for Illinois hospitals as they pursue high reliability in healthcare. This webpage will be updated regularly with information and resources for Michigan hospitals as they pursue becoming HROs.

Last update: 5/12/2017