Discussion Question 4.1 Paper

Discussion Question 4.1 Paper

Discussion Question 4.1 Paper

A high-reliability organization (HRO) refers to an organization that has succeeded in evading tragedies despite experiencing a high level of risks and intricacies (Polonsky, 2019). According to Serou et al. (2021), there are different elements necessary in creating HRO. One is the preoccupation with failure. HROs address process failures instantly and completely. No failure is ignored by the HROs irrespective of how small it may be because a shift from projected results can lead to tragedy. The second element is the reluctance to simplify. Complex issues in HROs get complex solutions. HROs perform root cause analysis and rebuff plain diagnoses.

The third element is sensitivity to operations. There are no assumptions in HROs and every voice matters, especially from the front-line operators who are closer to operations of the organization. The other element is the commitment to resilience (Serou et al., 2021). The recovery is swift in HROs since they prepare in advance for crisis and have logical means of communication and control. The final element is deference to expertise. Professionalism, instead of authority, is prioritized in HRO. HROs understand that circumstances can change faster and situations can be high-risk. Experts are critical for quick situational evaluation and response.

HROs, safety, and quality are related in various aspects. HROs utilize systems thinking to assess and design for safety. They understand that safety is emergent and not fixed. New threats to safety often appear and doubt is widespread (Serou et al., 2021). Therefore, HROs strive to create an environment where probable problems are projected, discovered in time, and acted promptly to avoid the crisis. HROs also imply consistent superiority in quality across all services sustained for long period. The high-performance level includes eradication of major quality failures and the use of a practical framework for improvement.

The approach a nurse administrator can use to execute the elements in an organization includes a framework organized around three domains including leadership dedication to the goal of zero harm, a culture of safety in the organization where all employees can voice their concerns about things that would adversely impact the organization, and empowering the workforce to use Robust Process Improvement (RPI) tools to work on improvement opportunities to drive lasting change (Serou et al., 2021).

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Polonsky, M. S. (2019). High-reliability organizations: the next frontier in healthcare quality and safety. Journal of Healthcare Management, 64(4), 213-221. DOI: 10.1097/JHM-D-19-00098

Serou, N., Sahota, L. M., Husband, A. K., Forrest, S. P., Slight, R. D., & Slight, S. P. (2021). Learning from safety incidents in high-reliability organizations: a systematic review of learning tools that could be adapted and used in healthcare. International Journal for Quality in Health Care, 33(1), mzab046. https://doi.org/10.1093/intqhc/mzab046


Please respond to each question individually
3.1. Discuss the purpose of conducting an organizational needs assessment. What needs have you identified in your clinical/practicum setting? What tools did you utilize to determine that need? What will the focus of your project be?
4.1. Describe the elements necessary in creating a high-reliability organization (HRO)? How are HROs and safety and quality related? What approach can the nurse administrator use to execute those elements in an organization?


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