High Reliability Organizations (HROs)

High Reliability Organizations (HROs) - Toolshero

High Reliability Organizations: in this article, you will find a practical explanation of High Reliability Organizations (HROs). After reading this, you will understand the basics of this concept.

What are High Reliability Organizations (HROs)?

High Reliability Organizations (HROs) are types of organizations that maintain a very high level of safety and reliability. These organizations are able to do this by planning for anomalies or rare events, rather than normal operations.

High Reliability Organizations (HROs) make less errors and when they do occur, they ensure that meaningful information is disseminated throughout the organization in an accurate and timely manner. This allows employees to be aware of mistakes and correct mistakes quicker and more efficiently.

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The framework consists of four components:

  1. The ability to plan for contingencies
  2. Rapid error detection
  3. Organizational learning
  4. The ability to prevent errors from recurring

Unlike industries such as aviation and nuclear power, the healthcare industry does not have a legal requirement for safety in many countries. In fact, in some countries, there is no penalty for failing to meet the standard of care in the medical profession. In addition, due to confidentiality laws governing patient records, it can be difficult to assess whether providers are following best practices even when they exist.

These factors combined with an increasingly complex health care system make it unlikely that a healthcare provider in such countries knows what a safe practice even looks like. Therefore, if doctors were trained to follow high reliability organizations frameworks, we could see significant improvements in patient outcomes.

One way that high reliability organizations learn from mistakes is by establishing a “just culture”. A just culture means that there is no retribution for reporting medical errors or mistakes. The Joint Commission sets out six core elements of just cultures in healthcare:

  1. Promote safety as a top priority
  2. Promote teamwork and collaboration
  3. Create open communication
  4. Validate contribution of individual contributions
  5. Reward individuals
  6. Educate all members on error reporting

The Joint Commission has also set out seven steps to take when responding to an unanticipated outcome:

  1. Identify the problem
  2. Determine causality
  3. Evaluate the actions to prevent it from happening again
  4. Discuss mitigation plans
  5. Implement plans
  6. Review lessons learned
  7. Share results with interested parties

HROs are able to disseminate information throughout the organization through multiple channels. These include, but are not limited to:

  • Artifacts left behind at the scene of an event;
  • Informal communication between team members;
  • Formal communication through checklists and meetings;
  • Management activities such as disciplinary action or commendation for individuals involved in an event;
  • Task forces who investigate events by gathering data from all relevant sources to determine what went wrong and how to mitigate risk in the future.

High reliability organizations are essentially close working teams. Teams range in size from two or three people to several dozen or even hundreds of people. The ideal size for a team is five to nine members, however, there are some smaller teams that have been successful with just one member.

These small groups are typically known as lone rangers, and they typically do not work well on their own if the issues they face become too difficult or complicated. However, having multiple lone rangers provide backup for each other can be an effective way of tackling large problems.

Skills in communications for solving problems

Communication skills are essential to the success of any team or organization. Clear communication can prevent unnecessary stress or anxiety, and is good for worker morale. There are many ways to improve communication skills, but one way is to practice active listening.

Active listening is about more than just hearing the words that people say; it means giving them your full attention–making eye contact, paying attention to their tone of voice, and showing them you care by summarizing what they’ve said so they know you understand. The goal of active listening is not to interrupt someone with an answer before they finish their sentence. If you only listen half-heartedly, other people might think you don’t care about what they’re saying and stop talking altogether.

Another way to improve communication is to communicate less, or more specifically, to communicate selectively. When you’re communicating with someone who isn’t working at the same level of urgency as you are, it’s easy for them to misunderstand what you need from them and cause unnecessary stress or anxiety.

For example, if one nurse has five patients waiting for her in the triage area and another nurse comes up asking for help moving equipment around, it can be frustrating because there’s no way for either nurse to know how long the other will take.

It might seem like they should both just ask each other, but it doesn’t always work out that way; people might forget to ask, or they might not feel comfortable asking, so they just pretend nothing’s wrong. But if one nurse says, “I have five patients waiting in the triage area,” and the other nurse understands this without being told everything, then you can avoid a lot of potential miscommunication.

When you communicate selectively, you create clarity about what your goals are and how much time you need, so teammates know when to ask for help and when to leave them alone.

To improve communications within HROs it is important that everyone follows the same rules with clear leadership, so there aren’t differing levels of urgency between different teams.

HROs take time to develop into safe organizations because you cannot build them overnight. It takes months or even years of working together.

Principle of High Reliability Organizations

High-reliability organizations are more than high-performing teams; they reliably perform in challenging, complex working environments characterized by significant uncertainty and stress.
There are four principles that define this type of organization:

  1. Commitment to resilient performance
  2. Shared mental models
  3. Competence
  4. Mutual trust and accountability

We will higlight the first two principles below.

Principle 1: Commitment to Resilient Performance

High reliability organizations are committed to ongoing performance improvement in all aspects of their work that will maximize their ability to remain resilient in the face of potentially catastrophic events.

This strategic goal is designed to ensure that attention is paid in a sustained way across all facets of HROs’ operations, rather than being limited to just high priority areas.

To achieve this ongoing commitment, HRO managers link goals for improving individual and organizational resilience with goals for increasing market share or productivity, so it becomes part of the organization’s culture. This linkage makes it clear how each facet contributes to overall success.
The second key attribute of commitment to resilient performance is the focus on process over outcome. In particular, HROs’ long-term success depends more on adhering to key processes and procedures than on meeting outcomes.

For example, the National Transportation Safety Board (NTSB) found that in aviation accidents, even when pilots or air traffic controllers deviated from policies and procedures—a clear violation of the rules—the accidents were still preventable if proper precautions had been taken.

As such, High Reliability Organizations actions are more predictable because they tend to follow routines and standard operating procedures (SOPs), while non High Reliability Organizations perform tasks in a more ad hoc fashion.

Principle 2: Shared Mental Models

Organizations with effective error management believe that an organization’s ability to learn from mistakes is largely determined by how well all employees understand their common goals and assumptions about their shared environment.

In order to facilitate collaborative error management, HROs have a number of practices in place that allow them to minimize the frequency and impact of errors by developing shared mental models among team members. In particular, these organizations

  1. Establish common goals for their groups
  2. Create strong social pressures toward following SOPs and staying attentive to mission-critical tasks
  3. Develop an understanding of how team members’ actions will affect one another
  4. Conduct routine readiness reviews (RRRs)
  5. Encourage participation in after-action reviews (AARs)

Establishing common goals

HRO managers make it clear that the organization’s work is much more important than any individual contributions they might make. This objective naturally creates a positive social pressure toward adherence to key rules and procedures.

Creating strong social pressures

In addition, High Reliability Organizations have a variety of practices in place that discourage deviation from SOPs and adherence to their common goals. Social pressures are created by punishing rule violators with ridicule, ostracism, or expulsion. Since the group views itself as interdependent, these actions carry significant implications for team members’ well-being.

HRO managers also promote strong “grounding” ties between group members, which reinforces feelings of belongingness and conformity to group norms, so they act on behalf of the interests of the entire organization rather than just their own self-interests.

Understanding how team members’ actions affect one another

HRO managers also facilitate effective error management by ensuring that team members clearly understand the impact of their groups’ actions on other group members.

To do this, they:

  1. Conduct regular briefings to ensure that everyone has a common understanding of the organization’s norms and procedures (especially for new employees)
  2. Emphasize in AARs how each member’s contribution fits into the overall mission so individuals are held accountable for collective performance
  3. Require every team member to be familiar with all aspects of group activities before beginning work so they can anticipate potential sources of errors or system delays
  4. Avoid making mistakes themselves when teaching others about SOPs since it sends mixed signals about what is acceptable behavior
  5. Design AARs to generate feedback and ideas for improvement rather than focusing on blame and punishment

Following SOPs

High Reliability Organizations make it clear that following their Standard Operating Procedures is the only way to ensure optimal performance, which encourages individuals to stay focused on their tasks even in times of stress.

Even when team members’ jobs leave them overworked and under tremendous pressure, they still follow procedures because they know that other group members will hold them accountable.

Participating in AARs

Effective error management requires learning from mistakes after they occur. HRO managers require all team members to participate in and contribute to After Action Reviews and encourage sharing lessons learned through challenging or provocative questioning during meetings.

During these activities, leaders try not to direct the conversation. Instead, they strive to ask open-ended questions in order to promote critical thinking and reflection.
By doing this, managers facilitate group learning by allowing team members not only to share their perspectives, but also to learn from each other.

Benefits of High Reliability Organizations

HROs are more successful at managing errors and near misses because they have a number of interlinked mechanisms in place to control the four principles of error management:

  1. Encourage people to stay vigilant
  2. Ensure that all relevant information is available
  3. Maintain vigilance over operations through the use of warning systems and other means
  4. Hold individuals accountable for their performance by ensuring that it can be monitored

This fosters a safety-conscious environment where team members work together toward common goals while adhering to rules and procedures designed to assure optimal performance toward those ends.
In this way HROs provide a model that should inform how risk is managed in complex sociotechnical systems.

Examples

The US military have been able to achieve a high-reliability organization by following some of the rules that were listed earlier. One of the major elements is that people are punished for violating policies, which creates a sense of belonging and accountability. The US Military also has a culture that emphasizes on group cohesion, where there is a shared perception that members have a stake in one another’s well-being and success.

Another example is Amazon, one of the ways that Amazon has been able to manage risk is by encouraging teamwork. Amazon employees are evaluated on how well they work together as a team. Amazon has also shown significant success in reducing error rates because it doesn’t allow its employees to skip SOPs and this fosters an environment where people are encouraged to stay vigilant.

Summary

In summary, HROs are able to reduce errors and near misses because they provide a protective structure that encourages individuals to follow rules or Standard Operating Procedures (SOPs), participate in After Action Reviews (AARs), and be accountable for their performance.

While the US military is one of the most successful examples of a HRO, companies such as Amazon have also shown success by creating a culture where employees are encouraged to work together toward common goals.

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Now it’s Your Turn

What do you think? Do you use High Reliability Organizations (HROs)-strategies in your own company or workplace? Do you think this is a good strategy to handle problems in a company? Do you have any suggestions or an opinion that you want to share with us?

Share your experience and knowledge in the comments box below.

More information

  1. Roberts, K. H. (1990). Managing high reliability organizations. California management review, 32(4), 101-113.
  2. Klein, R. L., Bigley, G. A., & Roberts, K. H. (1995). Organizational culture in high reliability organizations: An extension. Human relations, 48(7), 771-793.
  3. Cox, S., Jones, B., & Collinson, D. (2006). Trust relations in high‐reliability organizations. Risk analysis, 26(5), 1123-1138.

How to cite this article:
Ospina Avendano, D. (2022). High Reliability Organizations (HROs). Retrieved [insert date] from Toolshero: https://www.toolshero.com/strategy/high-reliability-organizations/

Published on: 03/17/2022 | Last update: 03/17/2022

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