Culture of Safety and High Reliability in Healthcare

Subject: Healthcare Institution
Pages: 4
Words: 915
Reading time:
4 min


The quality of work of healthcare organizations depends not only on the specific professional qualities of employees but also on the culture of institutions and their effective management. For this reason, this presentation will study the main elements that shape the organizational culture of healthcare institutions and methods of its improvement. The presentation will examine and compare such features as characteristics of high reliability, competing commitments, and Just Culture by using Conduent’s company case to illustrate theoretical concepts with practical examples.

A High-Reliability Organization’s Characteristics

Highly reliable organizations use a systems approach to predict, identify, and prevent non-systemic errors. Therefore, the first characteristic of such an organization is to focus on potential failures, which manifests itself in the constant analysis of the environment and actions to identify and prevent failure. The second feature is the refusal to simplify many tasks, which leads to considering the complexity and assessing all mechanisms and elements to avoid their failure (Nash et al., 2019). The third trait is situational awareness, which manifests itself in the understanding of each staff member of the processes at the individual, team, and organizational level and their role in these processes. The fourth characteristic is respect for experience but not just hierarchy in crises. The last trait is a commitment to resilience which means the commitment and ability to continually analyze and take action to identify and eliminate potential threats.

Conduent Company’s Characteristics

Conduent provides solutions for healthcare organizations to improve their patient experience, and payment system and provides data for trend analysis. The company’s activity and values ​​demonstrate some of the traits of a high-reliability organization. For example, external and internal communication with a purpose and teamwork provide error analysis and threat avoidance (“About,” n.d.). Consequently, the company is preoccupied with failures; all members have situational awareness and are also involved in projects and crisis management according to their experience. In addition, the company strives to receive feedback to reflect and analyze mistakes, which demonstrates its commitment to resilience. Thus, the company’s features and mission enhance the patient experience with healthcare organizations.

Competing Commitments

Competing commitments are a concept that explains the resistance to change or the emergence of conflict situations between individuals. Kegan and Lahey proposed a new approach, explaining that people can resist change, not because of their selfish desires or fears but because they have good reasons not to take action (van Nistelrooij, 2020). Most employees have such a competing commitment as the fear of provoking conflict in the team due to its cohesion and community; hence, they are often afraid to criticize other members. Since the organization is constantly talking about efficiency, there is also a fear of proposing changes that will not be effective enough, which interferes with creative ideas.

Leader’s Tools to Improve Culture

Conduent’s leaders can use such tools as briefly discussing safety issues during meetings, which can include new knowledge or practice repetition, hence, everyday learning. Rounding to influence also can be used to encourage and assists personnel in safe behavior (Nash et al., 2019). These tools are effective because they are suitable for employees of all levels and responsibilities, and any safety practice requires constant repetition. In addition, teaching and applying such techniques as STAR and SBAR to improve attention and communication helps to complete tasks correctly and avoid accidental mistakes. Adherence to protocols and critical thinking will help prevent errors due to a lack of knowledge. All of these tools should be used in Conduent company as they are simple yet effective and universal.

Importance of Just Culture

Just Culture is an essential element for any organization, particularly healthcare. This culture combines formal policies and informal communication that encourages employees to report errors in the workplace. This culture is based on the understanding that human mistakes are most often caused by external factors or system problems. Therefore, their analysis and understanding help eliminate safety threats. In this way, Just Culture ensures that employees are not punished for accidental errors, which assists in their analysis (Nash et al., 2019). For this reason, Just Culture is of paramount importance in healthcare, as the fear of employees being punished for failures hinders the improvement of the system and reduces its safety.

Just Culture Paths of Improvement

Conduent has a Just Culture that is reflected in the company’s policies, goals, and internal interactions by encouraging the reporting of errors and weaknesses in the organization. However, such an element as a learning system, in which the details of each case are analyzed according to a specific algorithm, is virtually absent (Nash et al., 2019). Although the problems are being studied, this process does not have clear procedures and deadlines. Therefore, the path to improvement is to establish a system that will include an analysis of the mistakes and successes of competitors, as well as internal processes in the company. This approach requires a step-by-step implementation that will help gradually accumulate knowledge and practices.


In conclusion, this presentation demonstrates that high reliability, which consists in analyzing and predicting errors, understanding the reasons for resistance to change and overcoming them, and promoting Just Culture contributes to a better patient experience. All of these elements are aimed at increasing the safety of the organization, which guarantees a better health outcome for patients. Conduent company demonstrates many of the traits that provide a safe culture for the organization; However, the company has areas for improvement, such as overcoming its competing commitments and establishing a learning system to enhance Just Culture.


About. (n.d). Web.

Nash, D. B., Joshi, M., Ransom, E. R., & Ransom, S. B. (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press.

Van Nistelrooij, A. (2020). Embracing organisational development and change. Springer Nature.