This document is written for hospital leaders interested in providing patients with safer and higher quality care. It presents the thoughts, successes, and failures of hospital leaders who have used concepts of high reliability to make patient care better. Creating an organizational culture and set of work processes that reduce system failures and effectively respond when failures do occur is the goal of high reliability thinking.

This tool addresses the following topics: 

• What are high reliability organizations and why do they matter?  
• Applying high reliability concepts in hospitals   
• Approaches to doing work
• Approaches to measuring progress  
• Using this information
• Appendixes—descriptions of site visits and case studies