Health Administration

What is a High Reliability Organization? 

The HRO is an organization that experiences fewer than anticipated accidents or events of harm, despite operating in a highly complex, high-risk environment. It has five key principles as seen below. 1

1. Veazie , Peterson K, Bourne D. Evidence Brief: Implementation of High Reliability Organization Principles. Washington (DC): Department of Veterans Affairs (US); 2019 May. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542883/S

From the Experts

High Reliability (2019). Patient Safety Network. Agency for Healthcare Research and Quality.

High Reliability and Infection Prevention (2024). The Joint Commission.

Measuring Quality in Hospitals in the United States (2024). UpToDate.

Journal Articles

• Polonsky MS. High-Reliability Organizations: The Next Frontier in Healthcare Quality and Safety. J Healthc Manag. 2019 Jul-Aug;64(4):213-221. 
• Sculli GL, Pendley-Louis R, Neily J, Anderson TM, Isaacks DB, Knowles R, Young-Xu Y, Gunnar W. A High-Reliability Organization Framework for Health Care: A Multiyear Implementation Strategy and Associated Outcomes. J Patient Saf. 2022 Jan 1;18(1):64-70.
• Veazie, S. , Peterson, K. , Bourne, D. , Anderson, J. , Damschroder, L. & Gunnar, W. (2022). Implementing High-Reliability Organization Principles Into Practice: A Rapid Evidence Review. Journal of Patient Safety, 18 (1), e320-e328.