Citation

Dwyer J, Karanikas N, Sav A. Safety Sci. 2023; 164: e106178.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.ssci.2023.106178

PMID

unavailable

Abstract

High Reliability Organisations (HRO) theory emerged from the study of nuclear power plants and air traffic control services that, despite their complexity and inherently high-risk operations, did not suffer from many serious accidents. Following decades from the conceptualisation of the HRO theory, the objective of this scoping review was to identify and analyse empirical studies to map how HRO has been practically applied as a unified and cohesive theory and its results evaluated. Although a considerable number of publications refer to reliability-seeking or HRO-like approaches, the search and screening of articles across four major scientific databases revealed only five (5) studies with empirical applications of the HRO theory inclusively, three (3) of which regarded the healthcare sector. The evaluation instruments employed were industry specific and claimed no cross-industry applicability, with studies recording improvements in various safety metrics post-implementation. The lack of a cohesive body of theory with specific guidelines to design and implement the HRO processes and the inherent difficulty to derive industry-agnostic methods for evaluating the impact of HRO applications could be barriers to broader research on implementing the HRO theory as a unified approach, leading to the lack of published empirical studies. Nonetheless, when considering the extensive number of scientific and industry publications inspired by the HRO theory but employing a subset and/or different and modified elements and principles of the theory to match different contexts, we should acknowledge its impact and resonance as a safety paradigm.

Language: en

Keywords

High Reliability Organisations; HRO; Safety management; Scoping review