Commitment to Workplace Safety as High Priority and Through Role Modeling

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A High Reliability Organization (HRO) is an organization that operates and manages processes with the potential to adversely affect human life or the environment (U.S. Nuclear Regulatory Commission, 2010). In healthcare, HROs strive to create systems and processes that prevent errors or mitigate their impact (The Joint Commission, 2012).

High reliability means consistent excellence in quality and safety across all services maintained over long periods of time. The Joint Commission^® has constructed a high reliability framework that healthcare organizations can use to work toward the ultimate goal of zero harm which includes (Joint Commission Center for Transforming Healthcare, 2022):

1. Leadership committed to the goal of zero harm.
2. An organizational safety culture where all staff can speak up about things that would negatively impact the organization.
3. An empowered workforce that employs robust process improvement tools to address the improvement opportunities they find and drive significant and lasting change.

HROs have systems in place that proactively accomplish their goal of avoiding long shift hours that can lead to patient and worker injuries. They are committed to worker safety and open communication, avoiding events in a blame-free environment where workers may report incidents without fear of reprisals (The Joint Commission, 2021).

Establish HRO principles that underscore a safe environment of care:

• Demonstrate knowledge about safe patient handling and mobility and its value to maintaining a safe working environment.
• Invest in technology and resources that replace unsafe practices with safe practices (e.g., ceiling lifts and floor-based and air lateral transfer devices).
• Communicate and model safety from the top down such as nurse executives and facility safety managers ensuring staff accountability for supporting a safe environment of care.
• Utilize the input of staff and their experiences with best practices such as with respiratory protection and sharps handling [Occupational Safety and Health Administration (OSHA), 2013] (e.g., employee/management safety committees).