This studied whether High Reliability Organising (HRO) interventions improved serious safety events (SSE), reporting and aligning leadership with frontline practice.
Was a retrospective observational design across 12 hospitals, between 2021-24. Usual limitations & cautions apply with these sorts of designs and measures.
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Extracts:
· The HRO intervention included leadership development, unified safety reporting, tiered safety huddles, and structured RCA feedback
· “Hospital SSERs decreased significantly by 71% (P < 0.001 for trend)”
· “Safety culture composite scores improved in 11 of 13 individual domains, with the largest percentage improvements in scores for leadership support and communication”
· “A systemwide, unified HRO approach that holistically incorporates HRO-aligned standard work, executive leadership alignment, and proactive systems design can result in lasting preventable harm reductions and cultural transformation”
· “The overall decline in hospital event reporting likely represents the normalization of reporting behaviors following the initial surge during the 2020 training”
· “The concurrent increases in clinic reporting validate the effectiveness of targeted ambulatory safety initiatives, demonstrating that contextually specific harm definitions and culture-building efforts successfully enhance transparency in diverse care environments”
· “Collectively, this suggests that the observed decline in SSEs represents actual safety improvements rather than decreased reporting or detection”
SafetyInsights.org 