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The purpose of this paper is to complicate and critique contemporary scholarship on high-reliability organizations (HROs). This paper argues that although HRO scholarship helps to identify communicative patterns that facilitate reliability and safety, it also simplifies processes that undermine the effectiveness of existing recommendations for HROs.

This paper frames high-reliability organizing as the enactment of mindfulness, which is the theoretical mechanism behind each of the five principles of high-reliability organizing. Using this framework, this paper then elaborates on each of the HRO principles: preoccupation with failure, reluctance to simplify interpretations, sensitivity to operations, commitment to resilience, and deference to expertise.

This paper details how research guided by HRO theory must address the following obstacles to safety and resilience: information accessibility limiting preoccupation with failure, identity constructions encouraging the simplification of interpretations, message fatigue repressing sensitivity to operations, the information environment within HROs weakening commitment to resilience, and generational differences impeding deference to expertise.

This paper highlights key issues obstructing safety and reliability in organizations that have been largely ignored by extant literature and encourages scholars to do more to acknowledge the role communication plays in constituting and reconstituting organizational reliability. Failing to fully address complex communicative interactions in HROs obstructs efforts to safeguard employee health and safety.

Both high reliability theory (HRT) and “new school” supply chain resilience (SCR) promote a multi-layered, adaptable, transformational, and holistic perspective on organizing and managing. The authors explore whether, and if so how, HRT offer fresh perspectives on the SCR challenges experienced during COVID-19 and on organizing for future resilience.

Addressing SCR at the interorganizational network level, and blending theory synthesis and case study research, the authors assess if and how HRN constructs and practices can guide analysis of SCR in dynamic, complex networks, and help shape development pathways towards organizing for resilience. Findings draw on thick description and iterative coding of data (58 interviews and 200+ documents) on the buyer network responsible for managing the supply of critical medical products in the Netherlands.

HRT highlights the interconnectedness of challenges encountered during COVID-19 and helps design future resilience through three lessons. Organizing for SCR requires (1) both anticipation and containment strategies, (2) stable working relationships characterized by trust, and (3) a clear basis of command underpinned by experience-based legitimacy.

Distinctive from SCR, which views crises as “black swans”, HRT organizes around everyday consideration of the risk of failure. Taking a buyer network perspective, the authors move beyond the buyer-supplier network focus in SCR. The authors contend that emphasis on measures such as supplier base management, stockpiling, and domestic production are essential but not sufficient. Rather, HRT implies that deep structural and social ties within the buyer network should also be emphasized.

High-reliability performance and high-hazard are intertwined in High-Reliability Organizations (HROs) operations; these organizations are highly safe, highly hazardous and highly significant for the modern society, not only for the valuable resources they have, but also the indispensable services they provide. This research intend to understand how HROs could produce high quality performance despite their challenging and demanding contexts. The research followed an emic approach to develop an organizational framework that reflects the contribution of the seeming traits of the organizations to the operations safety based on the workers point of views about the safety of workstations.

This research adopted mixed methods of in-depth interviews and literature review to identify the structural characteristics of high-reliability organizations (HROs) embedded in the organizations studies and developed a theoretical based structural framework for HROs. Furthermore, a systemic literature review was adopted to find the evidence from the organizations literature for the identified characteristics from the interviews from the first stage. The setting for this study is six Chinese power stations, four stations in Hubei province central China and two stations in the southern China Guangdong province.

The organizational framework is a key determinant to achieve high-reliability performance; however, solely it cannot explain how HROs manage the risks of hazard events and operate safely in high-hazard environments. High-reliability performance is attributed to the interaction between two sets of determinants of safety and hazard. The findings of this research indicate that HROs systems would be described as reliable or hazardous depending on the tightly coupled setting, complexity, bureaucracy involvement and dynamicity within the systems from one hand, and safety orientation, failure intolerance, systemwide processing, the institutional setting and the employment of redundant systems on other hand.

The authors developed an organizational framework of organizing the safety work in HROs. The applied method of interviewing and literature review was not adopted in any other researches.

Long-term care (LTC) organizations have struggled to protect their vulnerable clients from the ravages of the COVID-19 pandemic. Although various suggestions on containing outbreaks in LTC facilities have gained prominence, ensuring the safety of residents is not just a crisis issue. In that context, the authors must reasses the traditional management practices that were not sufficient for handling unexpected and demanding conditions. The purpose of this paper is to suggest rethinking the underlying attributes of LTC organizations and drawing insight from the parallels they have to high-reliability organizations (HROs).

The authors analyzed qualitative data collected from a Canadian LTC facility to shed light on the current state of reliability practices and culture of the LTC industry and to identify the strengths and weaknesses of the traditional management approaches.

To help the LTC industry develop the necessary crisis management capacity to tackle unexpected future challenges, there is an urgent need for adopting a more systemic top-down approach that cultivates mindfulness, learning and resilience.

This study contributes by applying the HRO theoretical lens in the LTC context. The study provides the LTC leaders with insights into creating a unified effort at the industry level to give rise to a high-reliability-oriented industry.

The purpose of this paper is to expand understandings of interorganizational collaboration among high reliability organizations (HROs). It proposes that HROs face unique needs for relationship building, pre-planning, and retrospective sensemaking that do not fit within prior models of collaboration. For HROs, definitions of collaboration vary contextually based on needs that arise during emergency situations. HROs have a need for both hierarchical structure and collaborative processes and use collaboration as a sensemaking frame that allows practitioners to attend to both needs.

The paper uses a case study from an ongoing ethnographic study of an emergency response collaboration. The paper uses open-ended interviews about collaboration with all key members of the incident response hierarchy, and participant observation of collaboration before, during and after a key emergency incident.

The paper proposes a new framework for HRO collaboration: that collaboration is a sensemaking frame for HROs used to make sense of individual actions, that HRO collaboration is more complex during pre-planning and focused on individual decision making during incidents, and that members can communicatively make sense of the need for hierarchy and collaborative action by defining these needs contextually.

The paper uses an in-depth case study of an incident to explore this collaborative framework; therefore, researchers are encouraged to test this framework in additional high reliability collaborative contexts.

The paper includes implications for best communicative practices to recognize the need to be both hierarchical and flexible in high reliability organizing.

This paper fulfills a need to expand collaboration literature beyond idealized and egalitarian definitions, in order to understand how practitioners use communication to understand their actions as collaborative, especially in organizations that also require hierarchy and individual actions. This case study suggests that collaboration as a sensemaking frame creates collaborative advantages for HROs, but can also limit sensemaking about incident management.

Given the pace of industry change and the rapid diffusion of high reliability organization (HRO) approaches, lags and divergences have arisen between research and practice in healthcare. The purpose of this paper is to explore several of these theory-practice gaps and propose implications for research and practice.

Classic and cutting-edge HRO literature is applied to analyze two industry trends: delivery system integration, and the confluence of patient-as-consumer and patient-centered care.

Highly reliable integrated delivery systems will likely function very differently from classic HRO organizations. Both practitioners and researchers should address conditions such as how a system is bounded, how reliable the system should be and how interdependencies are handled. Additionally, systems should evaluate the added uncertainty and variability introduced by enhanced agency on the part of patients/families in decision making and in processes of care.

Dramatic changes in the sociotechnical environment are influencing the coupling and interactivity of system elements in healthcare. Researchers must address the maintenance of reliability across organizations and the migration of decision-making power toward patients and families.

As healthcare systems integrate, managers attempting to apply HRO principles must recognize how these systems present new and different reliability-related challenges and opportunities.

This paper provides a starting point for the advancement of research and practice in high-reliability healthcare by providing an in-depth exploration of the implications of two major industry trends.

Purpose – To offer a theoretical explanation for observed physician resistance and rejection of high reliability patient safety initiatives.

Design/methodology/approach – A grounded theoretical qualitative approach, utilizing the organizational theory of sensemaking, provided the foundation for inductive and deductive reasoning employed to analyze medical staff rejection of two successfully performing high reliability programs at separate hospitals.

Findings – Physician behaviors resistant to patient-centric high reliability processes were traced to provider-centric physician sensemaking.

Research limitations/implications – Research, conducted with the advantage that prospective studies have over the limitations of this retrospective investigation, is needed to evaluate the potential for overcoming physician resistance to innovation implementation, employing strategies based upon these findings and sensemaking theory in general.

Practical implications – If hospitals are to emulate high reliability industries that do successfully manage environments of extreme hazard, physicians must be fully integrated into the complex teams required to accomplish this goal.

Social implications – Reforming health care, through high reliability organizing, with its attendant continuous focus on patient-centric processes, offers a distinct alternative to efforts directed primarily at reforming health care insurance. It is by changing how health care is provided that true cost efficiencies can be achieved. Technology and the insights of organizational science present the opportunity of replacing the current emphasis on privileged information with collective tools capable of providing quality and safety in health care.

Originality/value – The fictions that have sustained a provider-centric health care system have been challenged. The benefits of patient-centric care should be obtainable.

Drawing on the social exchange theory, the authors extend the high-reliability literature by examining employees' subjective experience of working in contexts engaging in mindful organizing (MO). Ultimately, they ask the question about how MO affects employees' attitudes and behavior toward work and organization, such us organizational commitment (OC), motivation to work and organizational citizenship behavior (OCB), in ordinary business settings. The purpose of this paper is to address this issue.

The authors surveyed 307 employees from various industries, using paper-and-pencil questionnaires. A series of hierarchical regression analyses and structural equation modeling were performed to test our hypotheses.

The authors found that MO is positively related to employees' affective and normative commitment to an organization, and that affective commitment is positively related to motivation to work and OCB. The study also reveals that the affective commitment has a partially mediating role in the MO – motivation and MO – OCB relations. Although several researchers argue that the effectiveness of MO may be higher in an uncertain environment, the authors’ study indicates that the environment does not moderate the relationship between MO and OC.

To the best of the authors’ knowledge, this study is one of the first attempts to explore the effects of MO in a traditional (i.e. nonhigh reliability) business context. Furthermore, their findings prove that MO not only leads to higher reliability and greater safety, as previous studies show, but it also positively affects performance-related attitudes and behavior.

The purpose of this paper is to follow the general question, how technical rebreather divers ensure their survival during performing of highly demanding dives – and what organisations could learn from these practices. As one form of complex adaptive system, technical divers perform different routines before and during the dive. These practices are formally trained and also informally mediated and developed. After investigating theoretical concepts like high reliability organising, Safety-I and -II as well as organisational resilience management, the authors scope on the existing risk and resilience practices in technical rebreather diving. Finally, the insights of the empirical research are used to make the transfer to the field of management studies – and ask relevant questions regarding their applied resilience intelligence.

The empirical research is analysed by applying Hollnagel’s Functional Resonance Analysis Method (FRAM) which leads to the reconstruction of an extended resilience management model for technical rebreather diving. The model development bases on a field study which comprised 300 hours of observations.

The findings are depicted in an FRAM model that exactly shows how technical divers perform high reliability operations and thus manages and increase the resilience of their socio-technical system.

Research results show the depicted model and the potential learnings for organisations and organisational resilience. However, the research remains inductive and is qualitative. Deductive and quantitative research would enrich and complete the picture.

The research is informative and offers an interdisciplinary but comprehensive bridge between the specific high reliability organisations/resilience practice of technical divers and the potential learnings for organisations. Companies can take the identified categories and mechanisms to match them to their own resilience activities.

Increasing organisational resilience means to increase societal resilience and thus sustainability. The research aims to support this interdisciplinary learning process.

The originality lies in the research object itself (technical diving practices), that never has been researched with an FRAM before. It is an interesting, comprehensive and interdisciplinary show case that is used to derive practical considerations for companies to strengthen their organisational resilience.

This chapter describes the efforts of a team of health care workers to make a sub-acute health care facility (SCF) serving profoundly damaged children into a high reliability organization (HRO). To obtain this goal, the health care team implemented change in four behavioral areas: (1) risk awareness and acknowledgment; (2) defining care; (3) how to think and make decisions; and (4) information flow. The team focused on five reliability enhancement issues that emerged from previous research on banking institutions: (1) process auditing; (2) the reward system; (3) quality degradation; (4) risk awareness and acknowledgment; and (5) command and control. These HRO processes emerged from the change effort. Three additional HRO processes also emerged: high trust, and building a high reliability culture based on values and on beliefs. This case demonstrates that HRO processes can reduce costs, improve safety, and aid in developing new markets. Other experiences in implementing high reliability processes show that each organization must tailor make processes to its own situation (e.g. BP, U.S. Chemical Safety and Hazards Board, Federal Aviation Administration, U.S. Navy Aviation Program, and Kaiser Permanente Health Care System). Just as in the flexibility called for in organizing for high reliability operations, flexibility is called for in deciding which HRO processes work in specific situations.