HRO Tool of the Month recap, Part 2

December 21, 2021  //  FOUND IN: Updates & Resources

At Michigan Medicine, we are committed to a culture of safety and reliability. Over the past several months, we have promoted an array of different skills and tools as a reminder to hold ourselves to the highest standards of reliability. The goal is to use these tools in our everyday work, helping to make us a high-reliability organization. 

Below is a recap of the skills and tools we have shared over the past year. If you have a moment over the coming weeks, please review these skills in preparation for another successful HRO year.


When we use simple communication practices to show respect and create familiarity among team members, we strengthen our culture of teamwork.

  • Smile and greet others, even if it’s a simple, “Hello”.
  • Introduce yourself and others by using their preferred names and explaining roles.
  • Listen with empathy and an intent to understand
  • Communicate the good intentions of your actions
  • Provide the opportunity for others to ask questions

When we use simple communication practices, verbal or non-verbal, we strengthen our culture of teamwork. During the covid pandemic, it has been especially important to lean on teamwork and empathy.

To learn more about Universal Relationship Skills, please visit the links below. 

Refresh: HRO Universal Relationship Skills Overview

Refresh: HRO Relationship Skills

SBAR- Situation, Background, Assessment, Recommendation

SBAR has had a positive impact on communication and increased understanding in a variety of situations. It is a way to structure your thoughts for clarity and understanding.

Situation: What is the immediate problem? The headline.

Background: What is the relevant history related to the situation?

Assessment: What is your review of the situation and your perception of the urgency of the action needed?

Recommendation: What is your request or recommendation?

For more information on SBAR, click here

ARCC- Ask, Request, Concern, Chain of Command

ARCC is a very important piece of creating and maintaining a culture of safety. An explanation of ARCC is as follows:

Start by Asking a simple question. If the question doesn’t draw their attention to the problem, then Request a change, quickly explain why, and hand the dialogue back to them by adding “what do you think?” If the request doesn’t change their thinking, use the safe word “Concern” using the phrase “I am concerned that…” Even then, you still have Chain of Command. Use your Chain of Command to check your thinking and help you advocate for safety. 

To learn more about ARCC, click here.

Validate and Verify

This can be found under the reliability skill, “Questioning Attitude”. Questioning attitude is what ensures our choices are best for the given situation. It is both asking questions and questioning the answers. If things don’t make sense, stop and ask yourself or others a question. (Validate, and then verify the information).

For more information on Validate and Verify, click here. 

Cross Check and Coaching

Cross-checking is a habit of the mind that keeps our attention on the people, equipment and environment around us. This habit provides for instant awareness of problems. If you suspect there may be a problem, never hesitate to speak up as you just may save a life or help solve a problem. 

  • Cross-checking is watching out for each other and sharing situational awareness. Cross-checking with an assist is providing an on-the-spot second opinion.  

Situations will arise where more action is needed after a cross-check. Coaching, sometimes called peer teaching, is a practice habit that reinforces good habits in others and works to replace poor practice habits with good ones. 

For more information about Cross Check and Coaching, click here.

Know Why and Comply/Use Source Policies, Procedures, Protocols and Checklists

Know Why and Comply is a habit of the mind that ensures that choices are compliant with the organization’s best practices. Compliance has always been an important and vital piece of building a culture of safety. Without compliance, there would be chaos, fines, unethical practices and likely, patient harm. 

Use Know Why and Comply when making choices based on policy, procedure and protocols. It’s important to review the rule and the reasons the rule exists. Apply a questioning attitude. If the rule makes sense — then apply the rule in a way that meets the action and the intent of the rule. Blind compliance is not safe and rule-based errors occur when policies and protocols are not followed. 

All departments are encouraged to upload their PP&Gs by Dec. 31 in order to be compliant. 

To access the Leadership Skill of the Month, please visit the Path Forward website.