Becoming a High Reliability Organization: Operational Advice for Hospital Leaders

1. McKeon LM, Oswaks JD, Cunningham PD. Safeguarding patients: complexity science, high reliability organizations, and implications for team training in healthcare. Clin Nurse Spec 2006 Nov-Dec;20(6):298-304; quiz 305-6.
2. Weick KE, Sutcliffe KM. Managing the unexpected: assuring high performance in an age of complexity. San Francisco: Jossey-Bass; 2001.
3. Baker DP, Day R, Salas E. Teamwork as an essential component of high-reliability organizations. Health Serv Res 2006 Aug;41(4 Pt 2):1576-98.
4. Roberts KH, Rousseau DM. Research in nearly failure-free, high-reliability organizations: having the bubble. IEEE Trans Engin Manage 1989 May 36(2):132-9.
5. Forest Service, Rocky Mountain Research Station. Managing the unexpected in prescribed fire and fire use operations: a workshop on the high reliability organization. Washington, DC: U.S. Department of Agriculture, 2004. General Technical Report RMRS-GTR-137. Available at:

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We thank the authors, Steve Hines, The Lewin Group; Katie Luna, Delmarva Foundation; Jennifer Lofthus, Delmarva Foundation; Michael Marquardt, The Lewin Group; and Dana Stelmokas, The Lewin Group. Additional thanks to Dave Morrell, Delmarva Foundation, for graphic design.

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Page last reviewed April 2008
Internet Citation: References: Becoming a High Reliability Organization: Operational Advice for Hospital Leaders. April 2008. Agency for Healthcare Research and Quality, Rockville, MD.