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Can a hospital be a HRO? |
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A high reliability organization (HRO) operates at a high level of safety despite extreme inherent risk; examples include nuclear power generation and aviation. Can hospitals become HROs? Mark Chassin and Jerod Loeb of the Joint Commission discuss this in a recent article. They first point out that hospitals are currently not HROs; hospitals fail in every single characteristic of HROs. A culture of 'low expectations' permeate healthcare. HROs have a preoccupation with avoiding failure; health care workers "behave as if they accept failure as an inevitable feature of their daily work." Intimidation and poor communication are common, leading to a poor reporting culture. From this pessimistic assessment, the authors suggest that improvement is possible; implementation of HRO principles must be incremental using highly effective process improvement tools such as Lean/Six Sigma, supported by senior leadership and based in a functional culture of safety. |
