High Reliability Concepts: Insights of Value to Any Organization

Published on May 18, 2018
By: Trude Henderson, MA
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When I think of a place where miracles happen every day, where the highest focus, safety and consistency are critical, what scenes first come to mind? A neonatal intensive care unit, the control room of a nuclear-powered submarine or the busiest airport in the world. Few organizations are as at-risk or mistake-prone as these, but regardless of the industry, size or complexity, High Reliability Organizations (HROs) offer insights that can prove invaluable. A skeptic might respond, “Aren’t you comparing apples and oranges?” The answer might surprise you.
Understanding the nuances that make an HRO successful can be a challenge to outsiders, because the inner workings of many of these organizations, for good reason, are off-limits to the public. A neonatal intensive care unit, for example, has restricted access, but the difficulties of studying them are compounded by the fact that people don’t like to talk about death – especially death caused by a medical mistake. In 1984, Karlene Roberts, a professor at the University of California at Berkeley and a pioneer of HRO theory, gained an unprecedented entrée into “intrinsically hazardous” organizations, culminating in research that proved a milestone in the field.
An HRO can be defined as “an organization that conducts relatively error-free operations over a long period of time, making consistently good decisions that result in high quality and reliable operations.”  But wait, isn’t that what every organization strives for?
Industries that initiated the use of HRO concepts (1 through 5 below) included aviation, nuclear power, manufacturing and the military. In 2008, hospitals began adopting and applying High Reliability science and methodologies to their operations, with great success. HROs are adept at hard-wiring certain valuable behavioral traits into the organizational culture, with the potential to mitigate adverse or threatening effects.
Below are some key takeaways that can help you inspire superior performance throughout your organization:

1. HROs maintain a keen awareness, a “sensitivity to operations” and systems. They pay close attention to what is and what is not working. They know if they are winning or losing at any given moment. Decision-making and operational initiatives are based on information obtained via observation, surveys and other metrics. They take action to prevent errors.
   • Key takeaways:
     • Transparency and trust go hand-in-hand. People who are open and honest generally inspire greater esteem and confidence than others. The same applies to leaders, customers and organizations.
     • Companies that encourage transparency usually have higher-performing teams than those that do not. As Peter Drucker said, “What gets measured gets improved.”
     • Remaining mindful of where you are now and where you want to be helps you fill in the gaps, increasing the likelihood that you will achieve your goals.
     • Continuous feedback can result in better decision-making because it helps organizations learn more, improve their processes in real-time and reduce inconsistencies.
     • Big data, identified, analyzed and distributed appropriately, can be transformative, ultimately making a positive impact on day-to-day operations.

1. HROs resist the temptation to accept “simple” explanations for problems.They ask a lot of questions and challenge long-held beliefs, potentially resulting in improved source identification and understanding underlying causes.
   • Key takeaways:
     • Strive to provide a safe, open environment where people feel free to express their ideas and concerns. Albert Einstein said, “Insanity: doing the same thing over and over again, and expecting different results.”
     • Ask “why” as many times as necessary to get to the bottom of any issue.
     • Encourage employees to search for ‘blind-spots’ and challenge ‘phantom-rules’(long-held organizational beliefs) that serve to maintain the status quo and prevent your business from growing.

1. HRO’s are “pre-occupied with failure.” Employees at all levels are encouraged to ponder the types of problems that might result in work processes breaking down, slowing down or becoming dysfunctional. In addition, they routinely share their concerns and become involved in developing best practices across departments. Furthermore, they are deeply concerned about complacency, routine and lack of engagement.
   • Key takeaways
     • Try to de-stigmatize failure by communicating the importance of viewing challenges and negative feedback as opportunities for improvement. Be sure to reward such behaviors!
     • Provide frequent opportunities for meaningful conversations and collaboration. Sharing ideas gives your employees a sense of purpose while providing mutual benefits to the organization and the team.
     • Ensure that proactive behavior is fully understood and implemented. Settling for less can result in demonstrably negative consequences for people, budgets and organizations alike.
     • Proactive steps, such as anticipating the needs of customers, can provide a customized, more personalized experience, setting your organization apart from the pack.

1. HROs “defer to expertise.” Leaders push decision making to the front lines and genuinely listen to people equipped with the most knowledge and experience regarding the task at hand, whatever their title or status. They encourage conversations and problem-solving in the work area, as opposed to the occasional conference room meeting.
   • Key takeaways:
     • Try to discuss and resolve issues on-the-spot, rather than waiting for the occasional conference room meeting, but make sure that your conversations are out of earshot of your customers.
     • Level the playing field so that more people are motivated to address problems, generating ‘real impact.’ Ray Lewis said, “Greatness is a lot of small things done well.”
     • Draw on experts to solve problems. Research indicates that experts can better understand problems and identify trends and meaningful patterns.
     • Establish strong and diverse partner ecosystems comprised of employees, customers, partners and products. Research reveals that high-performing organizations prioritize people and form robust partnerships.

1. HROs “are resilient.” They relentlessly stay the course, never abandoning the continuous improvement process or straying from their purpose. They constantly refine processes and seek for better, more efficient ways of doing business. They are efficient problem-solvers and continuous learners.
   • Key takeaways:
     • Be a leader and a pioneer. Don’t be afraid of change or a challenge. John Quincy Adams said, “If your actions inspire others to dream more, learn more, do more and become more, you are a leader.”
     • When hiring and promoting employees, look for people who appear resilient in confronting obstacles. During stressful or tough times, resilient employees can help inspire others to remain calm and stay the course. They can be your best cheerleaders!
     • Never stop learning as an organization. Most employees want to learn and grow, and as the world continues to evolve technologically, it is indispensable to the growth and prosperity of your organization. The alternative to a learning culture is one that remains stationary, repeats mistakes and has high turnover, due to employees who are present in body but not mind.
     • Say ‘thank you’ often because it can help foster resilience. Employees who feel appreciated are more likely to endure the bumps in the road and continue moving forward. Employee energy, both positive and negative, can directly impact customers. Happy people equals happy, loyal customers!

To conclude: High Reliability Organizations have a sense of purpose, and they understand that ideal behavior drives long-term excellence and sustainable results. These high-performing organizations offer a plethora of valuable insights to any organization wishing to consistently accomplish its goals, avoid errors and maintain effectiveness.





Trude Henderson is the co-founder of ToothFairy, a startup elective dental and medical practice improvement software company which delivers an unparalleled customer experience that inspires delight, loyalty and positive emotional connections to improve the lives of patients and the practices they visit. In 2016, she was the first to introduce High-Reliability Organizational Concepts to the dental industry. For questions, contact her directly at Trude@GetToothFairy.com. Follow Trude on LinkedIn:  https://www.linkedin.com/in/trudehenderson/ (no email required).
Go to ToothFairy's website: www.ToothFairySoftware.com.