High Reliability Organizations (HROs) offer benchmarks for other organizations and systems whose missions are critical but operate in challenging high-risk environments. Successful HROs offer insights on operations, culture, performance, and evaluation that can be adapted to other organizations to improve the reliability of achieving objectives.
Early research on HROs attempted to understand how organizations such as aircraft carriers and the air traffic control system could continuously produce desired outcomes despite the high uncertainties of input conditions (environment) and the inherent interdependence of operations. Observing these unlikely success stories led to the distillation of 5 principles:
• A preoccupation with failure.
• Reluctance to simplify.
• Sensitivity to operations.
• Commitment to resilience.
• Deference to expertise.
Recently, managers in less fraught, but still complex, organizations and systems have begun to adapt these principles to deliver a similar high reliability in outcomes. Among others, good candidates for applying the lessons of HROs include the cash management system and healthcare organizations and systems.
The Joint Commission on healthcare accreditation is sponsoring work to develop a path for healthcare organizations of various sorts to move toward high reliability outcomes. A 2013 Joint Commission paper by Mark Chassin and Jerod Loeb titled “High Reliability Healthcare: Getting There from Here” summarizes a process to move toward the goal. An important point it emphasizes is that the improvement is continuous: HROs seek perfection, but never finally reach it.
Chassin and Loeb lay out stages healthcare organizations might follow on the journey toward becoming an HRO. Other types of organizations would have to adapt these to their own circumstances, but they do provide a template for moving forward.
High reliability organizations (HROs) operate within challenging conditions. Think of air traffic control, aircraft carriers, and nuclear power plants for clear examples of such conditions. Mistakes in these settings often have catastrophic consequences.
Yet they seldom fail.
HROs have the unique ability to deliver stunning reliability in complex environments. How do they do it? What makes an HRO? Our latest slideshow provides a glimpse inside. Read through it here:
One of the most fascinating things about High Reliability Organizations (HROs) is their paradoxical nature. Despite existing in potentially hostile conditions where factors not under their control can emerge at any moment, they achieve the capability to absorb the unexpected and continue operating successfully.
The High Reliability Organization (HRO) is an irresistible topic. How can any organization (like an aircraft carrier) or organized system (like American commercial aviation) operate in a totally threat-filled environment without frequent catastrophic failure? How can any organization realistically seek perfect reliability under conditions where the unexpected is routine?
Organization design experts have been working out the answers to these questions over the past 20 years. What has emerged from this research is a growing understanding about how an organization in a complex environment can become a resilient, adaptable HRO.
People working in HROs continuously seek ways to improve processes, and use every failure as an opportunity to install beneficial changes. They do not assume that just because something has worked well in the past that it will always continue to do so. The people and the system they are part of are open to change.
Early research focused on “heroic” organizations like the U.S. commercial aviation system. In 2015, there were about 24,000 commercial flights every day, operating through a network of 476 control towers and 14,000 controllers. Yet there were zero fatalities due to operations in commercial aviation that year.
Vivid outcomes like this helped to highlight how HROs operate to manage the unexpected. These same principles can be used in more ordinary organizations and systems to improve performance. A prime example is how healthcare organizations of different types are working diligently to adopt HRO principles.
This infographic, The Making of a High Reliability Organization, gives a fast summary of the characteristics of an HRO. Managers of every organization should be familiar with HROs to evaluate how they might adopt operational and cultural factors that lead to very high reliability to their own environments.