TY - JOUR
T1 - Manifestations of High-Reliability Principles on Hospital Units With Varying Safety Profiles
T2 - A Qualitative Analysis
AU - Mossburg, Sarah E.
AU - Weaver, Sallie J.
AU - Pillari, Marie Sarah
AU - Daugherty Biddison, Elizabeth
N1 - Funding Information:
This study was supported in part by a grant from the National Institutes of Health (NIH) NHLBI (K23HL098452 to the Johns Hopkins University) and a grant from the Johns Hopkins Institute for Clinical and Translational Research (ICTR), which is funded in part by grant number 1KL2TR001077-01 from the National Center for Advancing Translational Sciences (NCATS), a component of the NIH, and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily reflect the official views of the Johns Hopkins ICTR, NCATS, or NIH.
Publisher Copyright:
© 2018 The Authors. Published by Wolters Kluwer Health, Inc.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Background: To prevent patient harm, health care organizations are adopting practices from other complex work environments known as high-reliability organizations (HRO). Purpose: The purpose was to explore differences in manifestations of HRO principles on hospital units with high and low safety performance. Methods: Focus groups were conducted on units scoring high or low on safety measures. Themes were identified using a grounded theory approach, and responses were compared using qualitative thematic analysis. Results: High performers indicated proactive responses to safety issues and expressed understanding of systems-based errors, while low performers were more reactive and often focused on individual education to address issues. Both groups experienced communication challenges, although they employed different methods of speaking up. Conclusion: Some HRO principles were present in the language used by our participants. High performers exhibited greater manifestations of HRO, although HRO alone was insufficient to describe our results. Mindful organizing, which expands on HRO, was a better fit.
AB - Background: To prevent patient harm, health care organizations are adopting practices from other complex work environments known as high-reliability organizations (HRO). Purpose: The purpose was to explore differences in manifestations of HRO principles on hospital units with high and low safety performance. Methods: Focus groups were conducted on units scoring high or low on safety measures. Themes were identified using a grounded theory approach, and responses were compared using qualitative thematic analysis. Results: High performers indicated proactive responses to safety issues and expressed understanding of systems-based errors, while low performers were more reactive and often focused on individual education to address issues. Both groups experienced communication challenges, although they employed different methods of speaking up. Conclusion: Some HRO principles were present in the language used by our participants. High performers exhibited greater manifestations of HRO, although HRO alone was insufficient to describe our results. Mindful organizing, which expands on HRO, was a better fit.
KW - communication
KW - high-reliability organizations
KW - mindful organizing
KW - patient safety
KW - teamwork
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U2 - 10.1097/NCQ.0000000000000368
DO - 10.1097/NCQ.0000000000000368
M3 - Article
C2 - 30480611
AN - SCOPUS:85066399529
SN - 1057-3631
VL - 34
SP - 230
EP - 235
JO - Journal of nursing care quality
JF - Journal of nursing care quality
IS - 3
ER -