Appendix G: About the HRO Network

Becoming a High Reliability Organization: Operational Advice for Hospital Leaders


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In March 2005, AHRQ authorized the formation and support for a learning network that would focus on applications of high reliability organizing in health care. Participants would be organizational leaders from health care systems attempting to make these applications who wanted to learn from each other and from the emerging research in this area sponsored by AHRQ and others. From that point until spring 2007, AHRQ sponsored a range of activities designed to support this initiative. These activities included:

  • A kickoff meeting in Chicago that discussed the goals and potential activities of the Network.
  • A site visit to Sentara Healthcare.
  • A site visit to Exempla.
  • A site visit to Cincinnati Children's Hospital.
  • A site visit to Allina/Fairview.
  • A Web event focused on setting priorities for improvement initiatives.
  • A Web event focused on engaging physicians in improvement initiatives.

AHRQ and its contractors would organize and facilitate the events; network members would cover the time and costs required to attend. These activities were somewhat different from other projects sponsored by AHRQ. Members helped to choose the events and facilitated each event. The events tried to avoid extended presentations in favor of a much more interactive format where participants could ask questions about the things that mattered most to them.

Twenty systems ultimately participated in the Network. Most systems had multiple participants, all of whom shared an interest in the application of high reliability theory to their organization. One goal of the Network from its outset was to share both what has been learned and what has been achieved by the systems working to apply these concepts. This manual brings together many of those insights but cannot hope to capture the remarkable passion and perspectives of the Network members.

Allina Hospitals & Clinics
Ascension Health
Baylor Health Care System
Brigham and Women's/Faulkner Hospital
Christiana Care Health System
Cincinnati Children's Hospital
Exempla Healthcare
Fairview Health Services
Johns Hopkins Medicine
Kaiser Permanente–California
Lahey Clinic
New York-Presbyterian Healthcare Network & System
OSF Healthcare System
Sentara Healthcare
SSM Health Care
Trinity Health
University of California, San Francisco Medical Center
University of Mississippi Medical Center
University of Rochester Medical Center-Strong Health
Wishard Health Services

Current as of April 2008
Internet Citation: Appendix G: About the HRO Network: Becoming a High Reliability Organization: Operational Advice for Hospital Leaders. April 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/hroadvice/hroadviceapg.html