Sensitivity to Operations
This principle emphasizes the importance of leaders knowing and validating what is happening at the point of care. ASC leaders are responsible for knowing and validating adherence to expected policy and process and maintaining awareness of common failure modes in process while continuously considering how current operations support or threaten safety.
In practice
- utilize executive rounding and clinical process assessments in relevant areas of the facility; and
- ensure leadership presence—both physically and socially—to ensure expectations can be and are met.
- Facility administrators and directors of nursing have consistent time spent rounding to observe flow of operations and to engage with frontline staff to receive feedback about what is going well and where there is opportunity for improvement, and observe safety risks that require attention.
Commitment to Resilience
HROs approach failures with curiosity and a learning mindset. They lead teams to recover from setbacks by sharing and learning from mistakes, viewing failures as opportunities to improve, and responding quickly, with learning and correction where applicable.
In practice
- ensure staff are adequately trained to do their work and meet expectations;
- following events, conduct debriefs and share learnings across all staff and providers;
- foster a culture where learning from errors is celebrated; and
- build systems that support rapid recovery and adaptation.
Deference to Expertise
HROs seek and listen to insights from those closest to operations, regardless of hierarchy. Decisions are made by those with the most relevant knowledge, not just those with the most authority.
In practice
- empower all staff, at every level, to speak up about safety concerns;
- involve clinical experts in decision-making processes; and
- recognize and utilize the expertise of all team members. Consider:
- What does your sterile processing department have to say about orthopedic tray turnover? Where can they see risk?
Building a Culture of Safety and Excellence
Implementing HRO principles requires intentional leadership, robust systems and a commitment to transparency. Invest in clinical education, multidisciplinary collaboration and continuous improvement initiatives. By doing so, create an environment where safety is the overarching strategy, and every teammate is engaged in the pursuit of risk mitigation and harm prevention.
Becoming an HRO is a journey, not a destination. For ASCs, it means fostering a culture where safety is prioritized, failures are opportunities for learning and expertise is valued at every level. Ultimately, leaders set the strategy, model the behaviors and empower their teams. By living these principles daily, ASCs can ensure the safest, highest-quality care for every patient.