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Promoting health care safety through training high reliability teams

Department of Psychology and Institute for Simulation and Training, University of Central Florida, Orlando, Florida, USA

Correspondence to:
Ms K A Wilson
Institute for Simulation and Training, University of Central Florida, 3100 Technology Parkway, Orlando, FL 32826, USA; kwilson{at}ist.ucf.edu
ABSTRACT
Many organizations have been using teams as a means of achieving organizational outcomes (such as productivity and safety). Research has indicated that teams, especially those operating in complex environments, are not always effective. There is a subset of organizations in which teams operate that are able to balance effectiveness and safety despite the complexities of the environment (for example, aviation, nuclear power). These high reliability organizations (HROs) have begun to be examined as a model for those in other complex domains, such as health care, that strive to reach a status of high reliability. In this paper we analyse the components leading to the effectiveness of HROs by examining the teams that comprise them. We use a systems perspective to uncover the behavioral markers by which high reliability teams (HRTs) are able to uphold the values of their parent organizations, thereby promoting safety. Using these markers, we offer guidelines and developmental strategies that will help the healthcare community to shift more quickly to high reliability status by not focusing solely on the organizational level.

Abbreviations: CRM, crew resource management; HRO, high reliability organization; HRT, high reliability team

Keywords: high reliability organizations; teamwork; team training; patient safety

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