From HRO to HRE: Human-Centered Resilience Engineering as an Evolving Framework for Patient Safety Management

The health care field is at a critical moment. Progress on patient safety, outside some key quality measures, has stagnated, and health care professionals are seeing increased calls in the literature for balancing current approaches to safety with some more future-ready ones if they are to realize the level of improvement they seek. Yet, judging by the various action plans and structural measures put forth over the past few years or so, there is still a gap in realizing this new approach, even as an increasing number of organizations and agencies are open to the idea. In this article, the authors discuss complexity in health care and why a transformed approach to how health care professionals advance patient safety is being called for. The authors also describe the experiences of two health systems in manifesting a human-centered resilience engineering approach to driving performance in the complex, adaptive field of health care. The authors end by calling for renewed curiosity and courage from the health care safety community, and invite everyone to share and learn together as we progress toward a new approach to patient safety in health care.