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Our Journey to Becoming a High Reliability Organization

We are embarking on a journey toward Zero Harm. To get there, we will embrace change so that we may better serve our patients, team members and communities.

In declaring Zero Harm as the goal of every team member in the University of Maryland Medical System, we are also committing to a purposeful, transformation of our culture. 

This journey demands that we become a High Reliability Organization (HRO). 

High reliability is a way of thinking, behaving and working that helps organizations make their culture safer, their workplace healthier and their operations more consistent. It helps leaders and teams manage complexity and reduce risk. It allows them to correct issues early on before they become bigger problems.

The 5 HRO Principles That Guide Our Journey:

Deference to Expertise

To get things done right or better understand how to make improvements, we know that the people closest to the work — the people who do that work every day — are the experts. They are often the most familiar with the problem and know best how to fix it. Leaders and teams should listen and defer to those perspectives regularly.

Preoccupation With Failure

Complex, fast-paced environments like health care are prone to mistakes. Preoccupation with failure does not mean we focus on mistakes. Instead we must commit to learning why a process, piece of equipment or person could fail in the future and then taking action to prevent that failure from happening.

Reluctance to Simplify

Reluctance to simplify means we accept that the easiest interpretation of a situation is not always the right one. The most important part of solving a problem is making sure we fully understand what we’re trying to solve by digging into an issue to truly understand it.    

Sensitivity to Operations

We each adjust the way we perform our jobs as circumstances change. Sensitivity to operations means we review data from lots of different sources to get a real-time understanding of what’s happening in our work setting and adjust when necessary. At the same time, we carefully consider how those changes might impact our patients and teams over time.

Commitment to Resilience

Commitment to resilience is being able to keep things running during an unexpected event or prolonged situation and recover quickly afterward. Organizations that think ahead about what might go wrong during a crisis, and practice how they would respond, get better at managing significant disruptions.