Do you know your HRO leadership tools??

March 17, 2022  //  FOUND IN: Strategy & Leadership

With Patient Safety Awareness Week falling in the middle of National Recognition Month, this seems like an appropriate time for leaders to make their teams aware of safe and reliable skills, while also recognizing them for considering safety first.

The following skills from the HRO tool kit are particularly appropriate for building a culture of safety. 

Putting Safety First in Decision Making

To become a High Reliability Organization (HRO), a leader should always consider Safety First in Every Decision. This tool reminds leaders and their teams to openly talk about safety before important decisions are made, even if their discussions do not result in a change in process, procedure or event.

Here are some questions leaders and their team members should ask when making critical decisions which could impact the safety of patients or faculty, staff and learners.

  • Will this make the patient(s) more likely or less likely to have a good outcome?
  • Will this increase the probability of harm? Or create the possibility of a different kind of harm?
  • How do we know that this will be just as safe? Or just as effective?
  • Are these demands too much on my staff?
  • What other solutions can we consider?

5:1 Feedback

This skill recommends that leaders should reinforce, reward and model safe and reliable behavior more frequently than using negative reinforcement, which tends to point out what employees don’t do correctly. When you recognize those who complete tasks in a safe manner and share those examples with others you teach and reinforce safe skills while building trust among the team.


Rounding is a first-hand opportunity to connect with team members and communicate safety and reliability expectations. Leaders can provide real-time feedback and coaching to employees while members of the team can share concerns, ask questions and help identify solutions for issues that impact their day-to-day work.

These are just three of many leadership HRO skills. A complete High Reliability Leadership Skills training (SAFE-C90238) is available in MLearning, but you can review certain skills by clicking on specific units, which are listed below:

  • Unit 1 – Introduction
  • Unit 2 – Establish Safety as a Precondition includes Safety First in Every Decision, Stand up for those who Speak Up & Chain of Command 
  • Unit 3 – Safe and Reliable Operations includes Huddles & Local Learning and Problem Solving 
  • Unit 4 – Building Engagement and Accountability includes Humble Inquiry, 5:1 feedback, Rounding & the 4C Model 
  • Unit 5 – Just Culture

For additional information, visit the High Reliability site or the Path Forward Website.