Which characteristic indicates a High-Reliability Organization (HRO) in healthcare?

• A. Reluctance to simplify
• B. Deference to expertise
• C. Preoccupation with failure
• D. Sensitivity to operations

Answer: (C)

In a high-reliability healthcare environment, teams stay focused on what could go wrong, not just what did go wrong. This preoccupation with failure means actively searching for signs of potential problems, valuing near-miss reporting, and analyzing small incidents to prevent larger harm. It creates a culture of continuous learning and system redesigns that make care safer, such as implementing safeguards, double-checks, and processes that catch errors before they affect patients.

While other traits like avoiding oversimplification, listening to the right people regardless of rank, and staying attuned to real-time operations are essential to reliability, the defining indicator is this constant vigilance for failure. It drives the organization to anticipate and prevent errors before they escalate.