Relationship of Safety Climate and Safety Performance in Hospitals

This study found that frontline personnel’s understanding of the safety climate was a better predictor of safety than supervisors’ understanding of the safety climate. It explored how patient safety indicators are affected by the overall safety climate. This supports the HRO principle of authority migration, where frontline, knowledgeable employees are empowered to prevent errors.

Singer, S., Lin, S., Falwell, A., Gaba, D., & Baker, L. (2009). Relationship of safety climate and safety performance in hospitals. Health Services Research, 44, 399–421. doi:10.1111/j.1475-6773.2008.00918.x

Organizing for High Reliability: Process of Collective Mindfulness

HRO enables adaptive learning and reliability simultaneously. The article includes a history of HRO theory and provides an explanation for where HRO fits in modern organizational development. The article includes a description of collective mindfulness, a theme recurring in HRO literature.

Weick, K., Sutcliffe, K., & Obstfeld, D. (2008). Organizing for High Reliability: Process of Collective Mindfulness. Crisis management, 3, 81-123.. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.465.1382&rep=rep1&type=pdf#page=37

Also cited as:
Weick, K., Sutcliffe, K., & Obstfeld, D. (1999). Organizing for High Reliability: Process of Collective Mindfulness. Research in Organizational Behavior, 1.

Learning from Patient Safety Incidents: Creating Participative Risk Regulation in Healthcare

This article’s authors discuss the concept of participatory regulation, where the employees of a firm help regulate safety beyond the level of outside or governmental agencies. A comparison is made between aviation regulation and medical regulation, and the authors discuss how the two industries can share insight. This is a component of HRO theory, which emerged in part from the field of aviation. It directly ties HRO to patient safety in a healthcare organization.

Macrae, C. (2008). Learning from patient safety incidents: Creating participative risk regulation in healthcare. Health, Risk & Society, 10(1), 53–67. doi:10.1080/13698570701782452

Identifying Key Nursing and Team Behaviours to Achieve High Reliability

The goal of this study was to measure behavioral markers among nurses during critical events in order to assess the extent of high reliability. The research method involved a simulation in order to observe communication between nurses. The authors cite previous studies that indicate that teams are more reliable than individuals. Improving channels of communication can contribute to increased patient safety. The article uses High Reliability Organization theory to improve patient safety.

Miller, K., Riley, W., & Davis, S. (2009). Identifying key nursing and team behaviours to achieve high reliability. Journal of Nursing Management, 17(2), 247–255. doi:10.1111/j.1365-2834.2009.00978.x

Patient Involvement in Patient Safety: Protocol for Developing an Intervention Using Patient Reports of Organisational Safety and Patient Incident Reporting

This article was designed to develop a plan for testing the validity and reliability of a new Patient Measure of Organisational Safety (PMOS) and the Patient Incident Reporting Tool (PIRT) in an effort to improve organizational safety in hospitals in the United Kingdom. The authors outlined an intensive, multi-year study in order to validate each instrument, and to determine how each instrument could support the other.

The instrument for including patients in the determination of the safety culture could be useful for a hospital-based study. The study can be used to determine employee attitudes on safety and to educate the staff on the importance of reliable case notes to prevent repeated unsafe incidents.

Ward, J. K., McEachan, R. C., Lawton, R., Armitage, G., Watt, I., & Wright, J. (2011). Patient involvement in patient safety: Protocol for developing an intervention using patient reports of organisational safety and patient incident reporting. BMC Health Services Research, 11(1), 130-139. doi:10.1186/1472-6963-11-130