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This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

Weick and Sutcliffe identified five principles that enable high-reliability organizations (HROs) to address environmental complexity and manage unexpected events. The current study aims to adopt this sensemaking perspective to analyze accidents within a typical HRO sector, namely maritime transport.

Through a retrospective case study analysis, this study focused on seven oil tanker accidents, using them as illustrative examples.

Findings show how the five principles contributed to the accidents' occurrence, explaining how failures in sensemaking affected the crew's capability to both prevent errors and cope with their consequences, thus leading to disasters.

Overall, the study offers an applicative contribution showing how this model may provide a reliable framework for analyzing the psychosocial factors affecting an accident. This approach deepens the understanding of how latent factors are enacted and how the prevention and error management phases interrelate within a comprehensive flow of the entire accident sequence. Furthermore, the study emphasizes consistent patterns that emerge across multiple accidents within the same sector, in order to learn valuable lessons to improve safety measures in the future.

This study constitutes an exemplary application in support of how Weick and Sutcliffe’s model is valuable for investigating HROs. It offers a second-order interpretative framework to understand accidents and underscores the interplay among these factors during the dynamic development of an accident.

This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies.

This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.

This paper identified that organizations within the health care industry can apply the principles behind being a high reliability organization effectively and improve outcomes.

The briefing saves busy executives, strategists and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

Since the outbreak of the COVID-19 pandemic, most organizations have experienced a sudden and unprecedented drop in revenue and productivity. However, the pandemic did not exclusively negatively impact organizations; rather, it resulted in both negative and positive effects. To delve into the multi-level process through which organizational outcomes change from negative to positive indicators, this study focuses on organizational resilience as a theoretical concept to overcome pandemic-related turmoil.

The authors conducted a multi-level analysis based on grounded theory with a sample of 30 healthcare employees who worked in hospitals and were simultaneously enrolled in a part-time master of business administration (MBA) program at a university in the Midwest. Of the 30 participants, 21 were from a single university hospital (UH), and the remaining 9 participants were from other hospitals (non-UH).

The authors analyzed the data and incorporated three existing perspectives of organizational resilience (attribute, process and multi-level views) into an integrated model. The authors identified 25 first-order concepts and 8 second-order themes and categorized them into 4 aggregate dimensions at different unit levels: organizational field, leadership, operation and individual units.

A resilient hospital operates as a cohesive system, with entities at various levels – from individuals and teams to the broader organization – collaborating seamlessly to foster resilience. Top management team (TMT) should persistently communicate with employees to provide information about the current crisis and clear strategic directions to reduce employees' fear and prevent anomie stemming from future uncertainty. Managers should not only be concerned about employees' physical safety from infection and psychological safety from isolation but also encourage employees to elicit meaningfulness from their work. Furthermore, TMT and human resource (HR) teams should adapt human resource management (HRM) practices to allow for flexibility and optimism in employee roles.

In this study, the authors utilized a qualitative methodology with grounded theory in order to develop a comprehensive model that holds theoretical, methodological and practical significance. Theoretically, the authors' novelty lies in the synthesis of three distinct perspectives: attribute, process and multi-level. The authors merged these approaches into a unified model, identifying precursors of resilience at different levels. Methodologically, the authors focused on hospitals as target samples, which were the foremost and representative organizations severely confronting the crisis and turmoil brought by the pandemic. The authors documented organizations' experiences amidst the crisis as they unfolded in real time rather than in hindsight. This approach highlights the immediacy and significance of the authors' research in the realm of crisis management. Practically, the authors' findings illuminate that organizational resilience can be developed through a collaborative effort. It emerges from coordinated interactions across various organizational actors, from employees and middle managers to the TMT.

Organizations working in high-hazard environments contribute significantly to modern society and the economy, not only for the valuable resources they hold but also for the indispensable products and services they provide, such as power generation, transportation and defense weapons. Therefore, the main purpose of this study is to develop a framework that outlines future research on systems safety and provides a better understanding of how organizations can effectively manage hazard events.

In this research, we developed the high hazard theory (HHT) and a theoretical framework based on the grounded theory method (GTM) and the integration of three established theoretical perspectives: normal accident theory (NAT), high reliability theory (HRT) and resilience engineering (RE) theory.

We focused on the temporal aspect of accidents to create a timeline showing the progression of hazard events and the factors contributing to safety and hazards in organizations. Given the limitations of the previous theories in providing a coherent explanation of hazard event escalation in high-hazard organizations (HHOs), we argue that the highlighted theories can be more complementary than contradictory regarding their standpoints on disasters and accident prevention.

A proper appreciation of the hazard nature of organizations can help reduce their susceptibility to failure, prevent outages and breakdowns of systems, identify areas for improvement and develop strategies to enhance performance.

By developing HHT, we contribute to systems safety research by developing a new, refined theory and enrich the theoretical debate. We also expand the understanding of scholars and practitioners about the characteristics of organizations working in high-hazard environments.

This paper aims to draw on historical conceptions of true and false prudence within the broader context of virtue ethics ideas, to create a prudence framework for developing risk-and-ethics cultures in organisations.

The authors use a theoretical analytical approach as a means of examining plausible representations of risk as ethical practice.

While the ethical ideal of true prudence is explained primarily with reference to psychological theories of generativity, false prudence is explained as undesirable, primarily with reference to psychological problems of narcissism and the broader dark triad. True and false prudence are represented as centring upon very different motivations for foresight, each of which might set the cultural tone for organisational risk management.

This paper’s main contribution is therefore to call attention to the benefits for organisations of reflecting upon differences between true and false prudence when planning the risk management they want.

Traditional management models are no longer viable in this complex era, with fast-pacing markets and various emergent properties affecting organizational success. The present study acknowledges the need for developing a coherent framework that leaders may use to evaluate their organizational adaptive ability.

This paper uses theoretical analysis.

This paper proposes the CAL-R framework, which identifies key characteristics of complex adaptive systems (CAS). These actionable elements, manifested in respective behaviors, will increase organizational adaptability. Adaptability is then suggested to be the mediating factor between complex adaptive leadership practice and organizational performance.

The suggested actionable elements are developed based on a theoretical, non-measurable approach; however, the need for statistical rigorousness is also acknowledged. Further research and a quantitative approach are also suggested for the development of a sound measurement scale.

Applying effective complex adaptive leadership will potentially provide organizations with a competitive advantage by making them more innovative, able to transform and adapt to environmental needs and changes and eventually meet their goals and reach their vision. Leaders may use the identified actionable elements as benchmarks against which they can evaluate their organizations' complex adaptive leadership readiness (CAL-R).

The CAL-R framework may be used by leaders in order to evaluate their organization’s current adaptive maturity level (ability) and identify the elements they need to focus on more and develop in order to become more adaptive and competitive.

Organizational exploration has recently emerged in the literature as an essential aspect of contemporary organizations. However, little is known about its antecedents and, specifically, the role of contemporary leadership styles. The present study investigates the relationship between empowering leadership and organizational exploration. In addressing this relationship, we examine preoccupation with failure and leader gender as a mediator and a moderator, respectively.

We collected data from a sample of 326 US employees in March 2022. To test the present hypotheses, we used the PROCESS SPSS macro.

Our results supported our moderated mediation model, demonstrating that the indirect relationship of empowering leadership with organizational exploration via preoccupation with failure is stronger for male leaders than for female counterparts.

Concerning the practical implications of this study, organizations should be cognizant of empowering leaders’ impact on desirable outcomes. Additionally, organizations should promote preoccupation with failure to ameliorate organizational exploration. Preoccupation with failure can be achieved when error reporting is encouraged by organizations and supervisors and when a culture that promotes constructive feedback is established.

The present study offers novel insights into the underlying mechanisms and boundary conditions through which empowering leadership relates to organizational exploration. Additionally, it fills a gap in the literature concerning the relationship between empowering leadership and preoccupation with failure. Moreover, it adds to prior research regarding the outcomes of preoccupation with failure, filling the gap regarding the relationship between preoccupation with failure and organizational exploration. Lastly, it expands limited research focused on leader gender as a condition under which the effect of contemporary leadership styles could be enhanced or mitigated.