High Reliability Organization Research: A Literature Review for Health Care

High reliability organizations (HROs) operate in hazardous, fast-paced, and complex environments yet avoid catastrophic accidents. Since the genesis of HRO theory in 1989, interest in HROs has grown beyond hazardous operations to many industries, including health care. This article reviews the literature to determine the extent to which changes made in health care organizations are aligned with HRO theory, and more specifically, with Roberts' Six Actions, which are based on HRO theory. The results suggest that HRO theory remains of interest to health care organizations. Implications for engineering managers and opportunities for future research are suggested.