Episode Summary

On today’s show, we discuss the practical characteristics of a high-reliability healthcare organization.

Episode Notes

To frame our discussion, we use the common High Reliability Organization Theory. A few people have authored papers on this topic and we will use their work during our chat.


  • What defines an HRO’s modus operandi.
  • Why it was revolutionary to study successful organizations.
  • Being transparent about research methods.
  • The difficult job of figuring out who the “expert” is, in a given situation.
  • The things that can encourage safety on a team.


“A number of organizations and industries have been linked to HRO theory over the years for maintaining somewhat error free operations over an extended period of time.”

“The technical name we use when talking about the position of the researcher, compared to the research they’re doing, is ‘reflexivity’.”

“It’s what model lets us make use of the local expertise and the professional expertise…as we’ve shifted to the model that gave primacy to the physicians, we lost that teamwork…”


Roberts, K. H., Madsen, P., Desai, V., & Van Stralen, D. (2005). A case of the birth and death of a high reliability healthcare organisationBMJ Quality & Safety14(3), 216-220.