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Re-examining high reliability: actively organising for safety

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  • The OMS Framework provides a company-wide, integrated approach to manage risk (including effects, impacts and threats) to achieve benefits and to optimise performance.

  • Contributors All of the authors contributed equally in conceptualising and reporting of the content described in this paper. Relative to the contributors, CGH reviewed and edited the structure and flow of the essay, and VG proofed and edited the essay.

  • Competing interests PJP reports receiving grant or contract support from the Agency for Healthcare Research and Quality, the Gordon and Betty Moore Foundation (research related to patient safety and quality of care), the National Institutes of Health (acute lung injury research) and the American Medical Association Inc. (improve blood pressure control); honoraria from various healthcare organizations for speaking on patient safety and quality (the Leigh Bureau manages these engagements); book royalties from the Penguin Group for his book Safe Patients, Smart Hospitals; and stock and fees to serve as a director for Cantel Medical. PJP is a founder of Patient Doctor Technologies, a start-up company that seeks to enhance the partnership between patients and clinicians with an application called Doctella.

  • Provenance and peer review Not commissioned; externally peer reviewed.