Locations:
Search IconSearch
June 14, 2017/Cancer/News & Insight

The Basics of High Reliability

A Cleveland Clinic physician defines the elusive term

Dr.Kalaycia_650x450

Matt Kalaycio, MD, Chair of the Department of Hematology and Medical Oncology at Cleveland Clinic, offers principles to help the healthcare industry enable high reliability at the system and individual level in his latest editorial in Hematology News. Dr. Kalaycio, Editor in Chief of the publication, describes the disconnect between physicians and administrators when defining and prioritizing high reliability.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“When the Joint Commission on Accreditation of Healthcare Organizations came to our hospital for a survey last fall, our administration was confident that the review would be favorable. The Joint Commission was stressing the reliability of hospitals and so were we. We had chartered a “High-Reliability Organization Enterprise Steering Committee” that was “empowered to make recommendations to the (executive board) on what is needed to achieve the goals of high reliability across the enterprise.” High reliability was a priority for our administration and for the Joint Commission. Unfortunately, nearly no one else knew what high reliability meant.

When physicians think about reliability, we think about reproducibility and precision. What often is less clear, then, is what our administrators mean when they discuss the importance of “high reliability” in a hospital or health care system.

Dr. Kalaycio offers five principles for organizations wanting to achieve high reliability, defined as reliable prevention or error, adapted from Managing the Unexpected: Resilient Performance in the Age of Uncertainty.

  1. Preoccupation with failure
  2. Reluctance to simplify interpretations
  3. Sensitivity to operations
  4. Commitment to resilience
  5. Deference to expertise

For individuals, Dr. Kalaycio argues that five similar principles, adapted from Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care, apply:

  1. Recognize failure as systemic, not personal
  2. Simple solutions are preferred to complex requirements
  3. Sensitivity to patients
  4. Resilience in character
  5. Deference to evidence

Advertisement

For more from Dr. Kalaycio on high reliability, read his editorial in Hematology News.

Advertisement

Related Articles

Head and neck cancer illustration
October 6, 2025/Cancer/News & Insight
Blood-Based Assay Shows Promise for Personalizing Treatment in Head and Neck Cancer

New research demonstrates that cfDNA methylation patterns may noninvasively identify tumor hypoxia in head and neck squamous cell carcinoma

Head & neck image contouring
October 3, 2025/Cancer/News & Insight
Subspecialty Peer Review Improves Consistency, Quality and Safety in Head and Neck Radiation Therapy

Program reduces major contour changes and variations in organ-at-risk dosing across health system

Breast radiation therapy
October 2, 2025/Cancer/News & Insight
Study Confirms Breast Volume Preservation with Five-Day Radiation Therapy

No significant differences seen in breast volume loss between whole and partial breast treatment approaches

CT scan after prostate brachytherapy
October 1, 2025/Cancer/News & Insight
Clinical Outcomes for AI vs. Physician-Drawn Contours After Prostate Brachytherapy Comparable

Despite wide variations in contours, researchers find AI and physician methods yield equivalent results.

Dr. Mustafa Ali and patient
September 30, 2025/Cancer/News & Insight
Cytogenetic Response to Treatment Correlates With Long-Term Survival of Patients With Acute Myeloid Leukemia

New system refines classification of cytogenetic abnormalities at time of response assessment and their clinical significance

Social worker with patient
September 9, 2025/Cancer/News & Insight
Oncology Social Work a Lifeline in Blood Cancer Treatment

Lifetime Achievement award-winner reflects on psychosocial support and caregiver readiness

Dr. Mustafa Ali & patient
September 4, 2025/Cancer/News & Insight
Comparison of First-Line Chemotherapy for Adults with Acute Lymphoblastic Leukemia

Questions remain about the merits of asparaginase-based therapy

Ad