• The High Reliability Organization (HRO) Council is a 501(c) (3) organization with a charter to urge Health Care Delivery Organizations (HDOs) to seek and continuously undertake efforts to become High Reliability Organizations (HROs). HRO’s are organizations that have a systematic process in place to prevent catastrophic errors, such as in the airline and nuclear power industries. The HRO Council will educate the public on the need for the healthcare industry to adopt HRO principles from these industries and others, in the interest of achieving significant improvements in patient safety. The HRO Council serves as a platform for education and collaboration, and supports the implementation of High Reliability Organizations in healthcare, government, and nonprofit entities.

  • Healthcare Policy, Accreditation and Patient Safety leaders (U.S. Congress, Joint Commission's Mark Chassin, Johns Hopkins' Peter Pronovost) understand that healthcare organizations have not yet achieved the level of reliability necessary for acceptable patient safety, and that this must change for the Public Good. The healthcare system continues to spend significant resources on technology and people, but errors still are too high and productivity is actually dropping. The HRO Council provides a means for the healthcare system to understand how to be more efficient and productive for taxpayers. This will, in turn, enable taxpayer dollars to be used for additional research, education, and implementation of preventive social and health services. Per the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), no organization has yet achieved HRO status, and it is continual journey. Approaching HRO status improves patient safety and the delivery of available, accessible, acceptable, continuous, cost-effective, and high quality care (3A2CQ) for active duty, retired members, veterans, and their families, and the general public.

  • HRO organizations are characterized by sufficient and high quality inputs (people, materiel, and equipment), stable, repeatable processes, and high outputs (preventive measures, admissions, visits, and procedures), that result in safe and ever improving health outcomes. Healthcare delivery processes are comprised of many individual tasks conducted by collaborative teams of clinicians, nurses, ancillary, and administrative staff. Human cognitive Task Saturation is a large, and not well understood, problem that affects patient safety across all healthcare facilities.

  • We believe that methodologies and technologies that can solve Task Saturation by redistributing the right task to the right person at the right time, for the right patient, and provide for acuity-based staffing, can improve cost-effective outcomes and patient safety, and can ultimately contribute to achieving HRO status realistically and sustainably.

    Bottom line: We are improving public safety and team reliability through combating task saturation.


  • Implementation of HRO principles in healthcare facilities is feasible given general systems-thinking and adoption of Total Quality Management (TQM) and Total Quality Leadership (TQL) principles widely known and practiced in the past. In addition, new U.S. DoD breakthrough research on Task Saturation, and Dr. Pronovost's “Fractal Organizational Structures” can help transform HDO’s into HROs.1

  • The Military Health System and VA Health System are working to further prove this solution, in conjunction with key academic medical centers and teaching institutions.

1. Per Raye, http://journals.isss.org/index.php/proceedings56th/article/viewFile/1796/663, fractal Organization Theory recognizes an emergent human operating system that is creative, adaptive, healthy, and evolutionary. The qualities of a fractal organization include “shared purpose and values that create pattern integrity; universal participation in ideas and solutions for continuous improvement; decision making at functional levels; leadership devoted to employee development as a source of intellectual capital; and competition energy directed outward instead of inward. In fractal organizations, resource allocation is based upon desired outcomes and information is shared efficiently through daily interactions and regular conversations, which generate ideas and enable economical development and delivery of products and services. Relationship development enables the effective flow of information between individuals and among teams. At all scales of a fractal organization, members share information iteratively and make decisions collectively in response to changing conditions.”


The HRO Council will:

  • Offer our methods and expertise on a no-cost basis to organizations that work exclusively for the Public Good.

  • Provide our time, methods and expertise to reduce suicides of Active Duty Service Members and Veterans on a charitable and non-profit basis, by improving the task execution of the teams that serve them.

  • Offer royalty-free access to patented methods and other intellectual property to charitable organizations that qualify.

  • Offer time and expertise on a volunteer basis by stakeholders to certain organizations that are deemed as serving public charitable causes. These can include live-webinar "strategy sessions" to help organizations serving the public interest to apply the HRO Council's new approach to making HRO feasible for those entities with limited resources.

  • Provide educational seminars, webinars, and website content (based on research and studies performed by HRO Council members and others' research) to organizations and teams that can benefit.

  • HRO understanding can also improve effectiveness of law enforcement teams, and other public safety and public health organizations, which can in turn help lower crime, reduce mortality during epidemics, and offer other benefits that can serve the Public Good.