Build High Reliability and a Strong Culture of Safety

Safety and High Reliability: A Foundation for Excellence

Gains in safety and reliability within your healthcare organization can be temporary unless you work to ensure that they become a part of your organization’s permanent, core processes. Make safety and high reliability part of your everyday culture by embedding these values throughout your organization. At the same time, understand specific actions and behaviors that can improve quality and become synonymous in your patients’ minds with the quality of care they seek and trust.

Benefits that accompany a strong culture of safety include not only a high level of patient care, but also a more engaged and competent staff, enhanced reputation, and increased financial stability. To advance your organization toward these goals, we encourage you to bookmark this page and access these resources as your organization progresses in its safety and reliability journey.


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Creating an organization with a strong culture of safety

Two people at work creating a learning culture

Top organizational characteristics: According to the Agency for Healthcare Research and Quality’s (AHRQ) Patient Safety Primer, these five attributes characterize highly reliable organizations:

  1. Preoccupation with failure as learning opportunity – Everyone in the organization is aware of and stays vigilant for potential threats. Near misses are opportunities to learn and prepare for future issues.
  2. Reluctance to simplify while embracing complexity – Staff members probe to understand the complexities of their work and look for deeper explanations for what is occurring, leading to discovery and improvement.
  3. Sensitivity to operations Teams understand how units within the organization interconnect and how conditions in other units can affect the safety and success of their own units.
  4. Deference to expertise People in the organization accept that those closest to a situation might know the most, regardless of status or hierarchy, and they feel empowered to speak up.
  5. Commitment to resilience Teams accept that failures will happen and are ready for rapid assessment and response to challenging situations, working to mitigate their seriousness.

Assessing your organization: What to Look For: Collecting data about where your organization stands where safety and reliability are concerned is key to knowing where you need to improve. Here are questions to ask, as derived from guidance from the U.S. Department of Health and Human Services, when beginning periodic organizational assessments:

  • How do staff members do their work?
  • How do you measure progress?
  • How do your teams respond to events in their external and internal environments?
  • What improvement initiatives does your organization need?
  • Which service types and clinical areas need specific improvement initiatives?
  • How can you replicate success across units and facilities?

By asking these questions, you can help identify, reduce, and mitigate existing risks in your organization. Look for areas that fall below benchmarks and address them with initiatives such as education, communication efforts, and policy revisions.

Addressing Maternal and Perinatal Safety: In 2020, the Centers for Disease Control reported the following sobering statistics:

  • In the U.S., 861 women died of maternal causes, up from 754 in 2019. The 2020 maternal mortality rate was 23.8 deaths per 100,000 live births compared with a rate of 20.1 in 2019.
  • The increase in the maternal mortality rate was highest for non-Hispanic Black women, increasing from 44.0 deaths per 100,000 live births in 2019 to a rate of 55.3 in 2020.
  • In 2019, the maternal mortality rate for Hispanic women was 12.6 deaths per 100,000 live births. This rate rose to 18.2 in 2020, a statistically significant increase.

Contributing factors to these statistics include variation in care and social determinants of health, which can both contribute to inequitable outcomes. Awareness of these factors, gained through robust diversity, equity, and inclusion (DEI) education for your teams and the consistent application of evidence-based quality practices, can help improve outcomes for your organization.

How mental health and social determinants are driving maternal mortality

How Mental Health and Social Determinants Are Driving Maternal Mortality Image

As a national leader in maternal safety, Relias is committed to helping you understand and address the complex interplay of clinical and nonclinical factors that contribute to the health of mothers and babies, including how social determinants affect maternal health outcomes.


Frameworks for quality care and reliable teams

Helpful frameworks can provide a basis for your quality efforts and include the following:

Diverse group of clinicians walking down a hospital corridor

Education and Its impact on risk and skill development

Relias empowers high reliability organizations (HROs) by supporting their commitment to being learning organizations. With a variety of solutions, we provide support through every stage of the high reliability journey by identifying opportunities for improvement and providing measurable results. Continuing education and personalized learning help create high reliability teams that excel at delivering quality care.

Through recruiting, onboarding, assessments, compliance, and over 7,000 clinical and non-clinical learning modules, the Relias Platform is with you every step of the way.

Short on time? Get these resources first

Reducing Maternal Death

Reducing mortality: Steps to improve outcomes

Despite the leaps and bounds made in healthcare in recent decades, the maternal mortality rate in the United States is still jarringly high. What, exactly, is the U.S. rate?

doctors talking with nurses in hospital

7 smart compliance tips to address risk management issues

Risk management in business is defined as the “process of identifying, assessing and controlling threats to an organization’s capital and earnings.” For hospitals, regulatory compliance requirements are at or near the top of this list, as healthcare is one of the most heavily regulated of all industries due to the care provided to vulnerable populations.

Improved maternity care

Improve Maternal Safety: Real Solutions for Multidisciplinary Education and Training

Patient care—in any care setting—relies on the attention, dedication, and training of more than one given discipline. Despite this obvious truth, most hospitals and health systems fail to incorporate enough multidisciplinary education and training into their organizations.

new mother at mental wellness check with provider

When Risks Collide: Maternal Mortality and Mental Health

Alarmingly, the maternal mortality rate in the U.S. is more than double the rate of 10 other high-income countries, according to a 2020 report from The Commonwealth Fund. The rate for non-Hispanic Black women is even worse — more than double that of non-Hispanic white women and nearly triple that of Hispanic women.

Older patient celebrating leaving hospital with care team

Patient Experience in Light of the COVID-19 Pandemic

As the COVID-19 pandemic takes new twists and turns, healthcare providers trying to optimize the patient experience continue to face many challenges. But the relationship between provider and patient continues to be a healing factor.

doctors and nurses reviewing medical chart

How Physician Buy-In Impacts the High Reliability Journey

The Agency for Healthcare Research & Quality (AHRQ) credits high reliability organizations with cultivating resilience by relentlessly prioritizing safety over other performance pressures.

nurse writing on clipboard close up

Invest in Wound Care Education to Avoid Legal Risks

When it comes to assessing and treating pressure injuries, diabetic wounds, and venous wounds, investing in expertise up front can help protect your organization against costly wound care liability down the road.

Resources for reducing risk

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Challenges for Hospitals: Creating and Maintaining High Reliability

The need to create a culture of high reliability within healthcare is not only long overdue, but it encompasses all elements to help organizations hone in on key drivers to effectively improve patient safety.

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Back to Basics

When it comes to patient safety, don’t overlook the fundamentals. Download this white paper to learn how to refocus your patient safety efforts against the aftermath following COVID-19.

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Patient Experience: Fundamentals and New Frontiers

Healthcare is experiencing a consumer revolution. Patients who were once willing to meet healthcare systems on their terms are now at the forefront of initiating change.

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Quality Care Teams: How Intentional Nurse Onboarding Improves Patient Safety

Healthcare systems are facing the harsh reality and enduring effects of the national nursing shortage. With nurses spending more one-on-one time with patients than any other healthcare worker, their ability to perform at the highest level is essential to providing safe patient care.

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Driving Return on Investment for Would Care Education in Hospitals and Health Systems

ailing to properly address and manage pressure injuries (or wounds) increases cost per case, places additional strain on already limited staffing resources, and increases the risk of reduced reimbursements, financial penalties, and litigation.

Resources for keeping mothers and babies safe

Social Determinants of Health

This report presents maternal mortality rates for 2020 based on data from the National Vital
Statistics System.

Maternal Mortality Survey Report

Giving Up Good to Become Great: Evolution of OB Safety Program

Promoting safety and providing quality care in obstetrics remains paramount for healthcare providers and medical professional liability insurers alike.

Changing the Narrative on Maternal Mortality

While the U.S. has become somewhat synonymous with advanced medical care, maternal care is lacking in quality.

How Sepsis is Impacting the Maternal Mortality Crisis

Despite having one of the most technologically advanced healthcare systems in the world, the U.S. has one of the highest maternal mortality rates of any country.

Maternal Mortality Toolkit

Resources about Maternal Mortality

How Relias Can Help

Relias helps you improve reliability and reduce variation in care by training clinicians to use an evidence-based approach to clinical problems. Understand what each clinician needs by assessing their knowledge and problem-solving to improve individual skill sets. Customized learning paths and plans for ongoing training help support clinician engagement, satisfaction, and fulfillment.

Ready to learn more about how Relias can help advance your patient safety culture and create highly reliable teams?

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