
High Reliability Organizations, Third Edition
A Healthcare Handbook for Patient Safety & Quality
By: Cynthia A. Oster, Jane S. Braaten
Hardcover | 22 September 2025 | Edition Number 3
At a Glance
508 Pages
27.94 x 21.59 x 2.87
Hardcover
RRP $190.29
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Patient safety and quality of care are critical concerns of healthcare consumers, payers, providers, organizations, health systems, and governments. Evidence shows that high reliability methods enable the most efficient, safe, and effective care; however, these methods are not the standard in all healthcare systems.
Nurses-who are on the front line of providing safe and effective care-are ideally situated to drive high reliability.
High Reliability Organizations: A Healthcare Handbook for Patient Safety & Quality, Third Edition, equips nurses and healthcare professionals with the tools necessary to establish an error detection and prevention system. In this new edition, authors Cynthia A. Oster and Jane S. Braaten build on the foundation of previous editions with best practices, relevant exemplars, and important discussions about cultural aspects essential to sustainability-solidifying process improvements and highlighting the contributing factors that lead to enhanced outcomes.
New material focuses on practical applications, including:
- Finding the essence of HRO
- Health equity
- Challenges to Just Culture
- Workplace violence
- Integrating patient experience
Industry Reviews
"Enhancing your people's adaptive capacity on the front lines makes all the difference-that is where resilience gets made and eroded. Healthcare systems, however, have a hard time getting that message through. Adding protocols, guidelines, policies, processes, and structures is easy, Oster and Braaten observe, but we should instead be understanding and supporting how practitioners on the front lines make successful outcomes occur in complex, dynamic environments. In this new edition of their push to change patient safety thinking, they have an A-list lineup of contributors exploring just how that might work in their (and your) area of patient care."
Sidney W. A. Dekker, MA, MSc, PhD
Professor
Safety Science Innovation Lab
Griffith University, Australia, and Delft University, the Netherlands
"Oster and Braaten have captured the essence of high reliability organizations, and this highly readable guide inspires organizations to do the right things to protect their patients while providing them with the tools to do so. The authors' experiences in these fields show, as each chapter is filled with attention to human aspects of high reliability as well as practical recommendations for creating high performance. These authors-themselves considered experts in the field-have assembled an impressive group of contributors to create this comprehensive text that answers both the 'why' and the 'how' of quality and patient safety efforts.â¯They bring a fresh, contemporary approach to a complex organizational challenge and a guide to achieving the state of high reliability, even in challenging times."
Janet Houser, PhD, RN
Provost, Regis University, Denver
Author, Nursing Research: Reading, Using and Creating Evidence, 5th Editionâ¯
"This is an outstanding resource for anyone interested in the theory and practice of high reliability organizing in healthcare. The 32 chapters in this thoughtfully organized handbook present a wide-ranging mix of theoretical frameworks, practices, and implementation strategies. The attention to the critical role of leadership, culture, and context in enhancing the reliability of healthcare delivery is especially noteworthy. This timely update is a welcome addition to the literature."
Rangaraj Ramanujam, PhD
Richard M. and Betty Ruth Miller Professor of Healthcare Management
Owen Graduate School of Management
Vanderbilt University
"The global quest to prevent patient harm and improve care quality and safety is paramount across all healthcare delivery settings. The second edition of High Reliability Organizations elucidates the connection among human and organizational factors, effectively integrating theory with pragmatic examples of health systems' progress and challenges. Shifting practice paradigms require effective use of innovation and technology to advance and sustain improved patient safety outcomes. Noteworthy new information includes content on the COVID-19 pandemic, resilience-building strategies, ambulatory care delivery, and telehealth considerations."
Ann Scott Blouin, PhD, RN, LFACHE
President, PSQ Advisory, Ltd.
Board and Executive Committee Member, Institute for Healthcare Improvement
Assistant Professor, Marcella Niehoff School of Nursing, Loyola University Chicago
Part 1: High Reliability - The Time Is Now
Chapter 1: The Need for a Paradigm Shift in Healthcare Quality and Safety Thinking
Chapter 2: Current Patient Safety Drivers
Chapter 3: Current Quality Drivers
Chapter 4: Organizational Culture and the Journey to HRO
Chapter 5: Safety Leadership: Commitment to High Reliability Organizing
Part 2: HRO Concepts and Application to Practice: Preoccupation With Failure
Chapter 6: Using Failure Mode and Effects Analysis to Predict Failure
Chapter 7: Close Calls and Near Misses: What's the Big Deal?
Part 3: HRO Concepts and Application to Practice: Reluctance to Simplify
Chapter 8: Human Factors Engineering for Reducing and Recovering From Error
Chapter 9: Root Cause Analysis: A Tool for High Reliability in a Complex Environment
Chapter 10: Just Culture and the Impact on High Reliability
Part 4: HRO Concepts and Application to Practice: Sensitivity to Operations
Chapter 11: Alarm Safety: Working Solutions
Chapter 12: Innovative Technology, Standardization, and the Impact on High Reliability
Chapter 13: Tiered Safety Huddles
Part 5: HRO Concepts and Application to Practice: Deference to Expertise
Chapter 14: Interprofessional Collaboration
Chapter 15: Nurses Create Reliable Care by Enhancing Engagement
Chapter 16: Pediatric Patient Safety: Utilizing Safety Coaching as a Strategy Toward Zero Harm
Part 6: HRO Concepts and Application to Practice: Resilience
Chapter 17: Resilience: A Path to HRO
Chapter 18: Designing Resilience Into the Work Environment
Chapter 19: Building High Reliability Through Simulation
Chapter 20: Building Resilience Through Team Training: Rapid Response and In-Hospital Cardiac Arrest Events
Chapter 21: Sustaining a Culture of Safety: Strategies to Maintain the Gains
Part 7: Assimilation Into Practice Across the Continuum
Chapter 22: Application of HRO Strategies to Improve Pain Management and Opioid Safety: The CNS Role
Chapter 23: Ambulatory Care: The Frontier for High Reliability
Chapter 24: Applying High Reliability Principles Across a Large Healt
ISBN: 9781646481972
ISBN-10: 1646481976
Published: 22nd September 2025
Format: Hardcover
Language: English
Number of Pages: 508
Audience: General Adult
Publisher: Nursing Knowledge International
Edition Number: 3
Dimensions (cm): 27.94 x 21.59 x 2.87
Weight (kg): 1.46
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