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Evidence Brief: Implementation of High Reliability Organization Principles

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Evidence Brief: Implementation of High Reliability Organization Principles

Prepared by:
Evidence Synthesis Program (ESP) Coordinating Center
Portland VA Health Care System
Portland, OR
Mark Helfand, MD, MPH, MS, Director

Recommended Citation:
Veazie S, Peterson K, Bourne D. Evidence Brief: Implementation of High Reliability Organization Principles. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #09-199; 2019.


Download PDF: Brief, Supplemental Materials

Background

The ESP Coordinating Center (ESP CC) is responding to a request from the VA National Center for Patient Safety for a rapid evidence review on implementing High Reliability Organization (HRO) principles into practice. Findings from this review will be used to inform the implementation of the VA's High Reliability Organization Initiative.

Key Questions

Key Question 1: What are the frameworks for guiding HRO implementation?

Key Question 1A: What are the main implementation strategies of these frameworks?

Key Question 1B: What were the processes for developing these frameworks (eg, consensus, literature review, etc)?

Key Question 1C: What are the intended settings of these frameworks?

Key Question 1D: Who participates in implementing these frameworks?

Key Question 1E: What are the processes for implementing these frameworks?

Key Question 2: What are the metrics for measuring a health system's progress towards becoming an HRO?

Key Question 2A: What are the main characteristics (ie, domains, scales) of these metrics?

Key Question 2B: What were the processes for developing these metrics (eg, consensus, literature review, etc)?

Key Question 2C: To what extent have these metrics been validated or used to inform health system decision-making?

Key Question 3: What is the evidence on HRO implementation effects?

Key Question 3A: On patient safety/organizational change goals (eg, number of sites that met goal of 50% reduction in serious safety events)?

Key Question 3B: On patient safety/organizational change measures (eg, mean change in number of serious safety events)?

Key Question 3C: On process measures (eg, mean change in inter-departmental communication, provider or patient satisfaction)?