How to Start and Sustain a System-Based High-Reliability Medicine Venture for Your Critical Care Organization

In recent years health care institutions have embraced the High Reliability Organization (HRO) paradigm as a way to enhance outcomes, reduce error, and improve safety. Furthermore, since large health care systems have also been organizing their critical care programs-typically multiple intensive care units across hospitals-into alliances known as Critical Care Organizations (CCOs), the conditions are ripe for CCOs to embrace the HRO methodology. This article is designed to introduce the HRO concepts, relate them into a critical care context, and suggest how a CCO may start and sustain a high reliability venture.