Describe the elements necessary to create a high-reliability organization (HRO). How are HROs related to safety and quality? What approach can the nurse administrator use to develop the necessary elements in an organization?
High Reliability Organizations (HROs) are organizations that achieve safety, quality, and efficiency goals. Applying high reliability concepts in an organization does not require a huge campaign or a major resource investment. It begins with leaders at all levels thinking about how the care they provide could be safer. A commitment to support and sustain a system of high reliability principles and safety should be an organization’s overarching strategy. Culture is the foundation for vision and strategy. At the core of an HRO, there are five key principles, which are essential for any improvement initiative to succeed: deference to expertise, reluctance to simplify, sensitivity to operations, commitment to resilience and preoccupation with failure.
in interpretation of current social changes in lifestyles with this ‘major paradigm of sociological thought’ with application to ‘formal rationality’ being ‘purposeful calculation’ in the ‘most efficient’ way for ‘means to an end’ can arguably be the ‘dominant aspect’ in post-modern society than ‘substantive rationality’ prior to that i.e. ‘an orientation towards ideal values and ends’ (Weber, 1904, Parsons, 1981). In the past, rational ideas concerning healthy lifestyles reflected more of an ‘ideal’ state as an end ‘value’ in strengthening beliefs in religion to increase spirituality of the soul with traditional holistic treatments, however, the modern society changed towards ‘formal’ methods ‘to look better, enjoy increased vitality, and enhanced life expectancy’ therefore modern trend towards healthier society arguably links to knowledge of rational choices whereby control over own health is calculated in the most efficient way controllable by each person freely (Weber 1904, Cockerham, Abel and Luschen, 1993). Ritzer and Walczak (1988) analysis of ‘formal rationality’ evidenced that for example, Americans had reduced relying on physicians as the main authority in their health matters, consequently ‘liberating’ the dependence on health ‘experts’ and therefore unlocking the ‘bureaucratic iron cage of dehumanization and overwhelming dependence’ (Ritzer and Walczak 1988, Weber 1904, Cockerham, Abel and Luschen, 1993). To date ‘formal rationality’ has evidenced that in the past society lacked ‘freedom’ or choice to be ‘creative’ in controlling their lifestyles, however, contemporary Weberian scholars have linked ‘formal rationality’ has encouraged freedom of choice for ‘healthier lifestyles’. Weber’s (1904) ‘formal rationality’ concepts was ‘sometimes ambiguous and inconsistent’ in how it was interpreted by sociologists, however, past interpretations on ‘dehumanization’ effects of bureaucratic systems as compared to ‘iron cages’ led to lack of freedom in choice, however, in comparison the contemporary sociologist has reversed the interpretation of the ‘dehumanization’ effects of the ‘iron cage’ to positive liberating the society with Weberian concepts towards gain of a healthier western society (Weber 1904, Cockerham, Abel and Lusche