Practical HRO: Optimizing Operational Risk Management using High Reliability Organizing

This podcast is part of our HRO and Healthcare focus. The episode features Sheeva Azma, founder of Fancy Comma and a freelance science, technology, health, policy, and business journalist. Her investigative journalism introduced her to High Reliability Organizing and how it can help overcome bias, racism, and burnout in healthcare workers.

Sheeva's research highlights the impact of Covid and Long Covid on patients, doctor's decisions, and burnout amongst health care staff. Improving and planning against this impact, HRO can help organizations make changes to their cultures to reduce the impact and improve the work environment.

Sheeva also has a relationship with the Patient Safety Movement Foundation. This organization is focused on patient safety in a variety of healthcare settings and situations. Like Sheeva the Patient Safety Foundation is committed to Zero Harm.

In this episode we explore the need for operational risk management by startups. I'm joined by Mr. Rick Gardener, executive director of the University of Buffalo's Business and Entrepreneurship Partnerships office. Rick has experience in all types of business settings from startups to NFPs. He holds 32 patents and brings a risk management perspective to his work.

When you talk about risk management for startups, Rick introduces the idea of moving from "the land of possibility" to a more firm perspective...  identifying the actual risks that are going to get in the way of bringing your product to market. This is often a challenge for founders, and may be especially applicable for tech startups.  

Rick sees an additional challenge for technical startups. The bulk of their work and thinking has been technical in nature. While it's important to overcome the technical obstacles, it is equally important to understand and plan for commercialization challenges.

Rick has some awesome insights and offers some best practices on dealing with risk and commercialization for startups.

Joining us in this episode is Dr. David O’Rourke, District Superintendent and CEO of Erie2 BOCES, a cooperative education service that works directly with school districts to offer needed special services for students and schools. 

We’re going to talk with David about managing risk in the middle of a crisis.  A crisis no one saw coming.  

We look at the operational, personnel, and student risks that had to be overcome, and we’re going to get some insight into how we can use this crisis as an opportunity for our schools. HRO requires that we learn from crisis and we are certainly going to need to incorporate HRO principles in our learning systems and facilities. David has a good start on that, having created an ad-hoc HRO organization in the midst of a raging crisis. Hat’s off to him and his team!

I was fortunate to have the opportunity to teach a class of Healthcare graduate students about HRO. I'm excited to bring this to the podcast. To make it manageable I divided this 90 minute introductory class up into a 3 Part Series.

This Episode is Part 3. It  introduces some of the human-centric aspects of HRO and what is important in implementing  HRO concepts.

Part 1 Takes class through a bit of history about HRO, as this gives important context as to why it's important an what it's about. From there the class learns the definition of HRO and we break that down to focus on the various aspects of HRO.
Part 2 I take the  the class through the  5 Habits of HRO, define them and look at some practical aspects of them.

I was fortunate to have the opportunity to teach a class of Healthcare graduate students about HRO. I'm excited to bring this to the podcast. To make it manageable I divided this 90 minute introductory class up into a 3 Part Series.

This Episode is Part 2. I take the  the class through the  5 Habits of HRO, define them and look at some practical aspects of them.

Part 1 Takes class through a bit of history about HRO, as this gives important context as to why it's important an what it's about. From there the class learns the definition of HRO and we break that down to focus on the various aspects of HRO.
Part 3 introduces some of the human-centric aspects of HRO and what is important in implementing  HRO concepts.

I was fortunate to have the opportunity to teach a class of Healthcare graduate students about HRO. I'm excited to bring this to the podcast. To make it manageable I divided this 90 minute introductory class up into a 3 Part Series.

This Episode is Part 1. I take the class through a bit of history about HRO, as this gives important context as to why it's important an what it's about. From there the class learns the definition of HRO and we break that down to focus on the various aspects of HRO.

Part 2 Takes the 5 Habits of HRO and defines them and looks at some practical aspects of them. Part 3 introduces some of the human-centric aspects of HRO and what is important in implementing  HRO concepts.

Every year, Santa is called upon to deliver the goods. This gripping expose' gives insight into the behind the scenes at the North Pole. In a slight tongue-in-check episode, we offer a collection of different HRO changes to consider, using Santa and his workshop to get you thinking outside of the toy box.

Practically speaking, HRO is hard.  There is so much to consider and the  challenge of knowing what effort makes the most sense first can seem as daunting as the mall the day before Christmas. Well, sit back, grab a hot cocoa and some cookies and listen to how Jolly Ole Santa Claus has built a High Reliability holiday juggernaut and give some thought to what to ask Santa for Christmas.

This is the season finale for this year. Many of you might be looking at some form of High Reliability implementation in the New Year and like many leaders are having a hard time identifying what’s your next (or first) step. I hope you enjoy today's season finale and all of this years episodes. Thanks to all the listeners and followers for helping grow our podcast this year. Next year is already taking shape.  Happy Holidays and Happy New Year!

Jeff Bezos may have coined the phrase "failure and innovation are inseparable twins", but Charlie d'Estries brings it full circle with his perspective that there is no difference between HRO and failure. In other words, Innovation and HRO both require failure.

Charlie, scientist, businessman, entrepreneur and author, brings his renaissance perspective to HRO. He offers a fresh take on how failure makes people, and companies, better at managing risk.

Nurses touch so many lives. They are the very front line on healthcare. They are the point at which hospital operations, risk management, and care giving come together. Their actions can literally be life or death, and certainly they are highly committed to the job they do and the folks they take care of (namely you and me).

This episode discusses the 5 principles of HRO in the daily setting of an oncology hospital. The conversation focuses on the daily operational efforts of nurses and concludes with an example of how HRO can be applied to a nurses daily responsibilities.

Thanks to Jacque Henry for her time and awesome stories.

Recognize:

 Recognize your people. Recognition positively impacts engagement. And right now, more than ever, an engaged workforce is your greatest asset and your best defense during this crisis.

In the frenzy and the disconnect between how we are used to working versus how we are working, leaders are not devoting enough time to consistently recognizing their people that pulled together to reinvent and sustain operations under tremendous duress.We aren't talking about a strategic approach to managing a transactional rewards program that spits out trinkets and gift cards. We are talking about the real deal; the human act of personally singing the praises and acknowledging the invaluable contributions of individuals and teams that made the impossible, possible.  

Let’s take a second to fundamentally make the hard-line connection between recognition and engagement through the lens of HRO. The down and dirty purpose of High Reliability Organizing is to avoid known and unknown catastrophic threats that could compromise operations and outcomes in complex, high stakes, fast-paced industries…healthcare, aerospace, and nuclear energy. Recognizing the power of engaged employees to protect the systems and processes that affect outcomes is at the heart of HRO.

 These are simple equations.

Recognized employees are energized and engaged employees.

Appreciative leaders are appreciated leaders.

 If you lead from your heart and your head through this crisis, you’ll emerge with an aligned and energized organization that is better prepared for whatever is coming next.  It doesn’t get any simpler than that.

The question is “What do you want more of?” An old friend used to say that “more is better” and when it comes to “improving the function of your organization”, you set the expectation and tone for what you will get more of…

Do you want more innovation, recognize it.

Do you want more expertise, acknowledge the power of it.

Do want a culture of engagement and proactivity, highlight it every time you see it.

 Great leaders speak the language of more.

If you want your working culture to adopt an aptitude for continuous improvement, you have to cultivate, recognize and reward it.

 Challenge the entire leadership team to recognize and elevate your people, privately and publicly, in real and meaningful ways.

Use your positions to raise others up. In doing so, you’ll improve the function of your organization.

 So, what you and your leadership team need to do is start is to schedule time to pop in to see every team and department across the organization, across all shifts. Come in early, stay late over as long as it takes. And when you get through every team and department, do it again. The goal is to recognize the expert contributions that teams or departments made throughout the transition that sustained operations or protected outcomes. Be specific. Plan to spend 30 minutes with the group. Find out what they need to succeed. Listen to them, support them, and thank them. Go into the experience with the intention of making a meaningful connection with the contributors, despite it being a group pow-wow.

Here’s the moral of the story…High reliability organization’s develop repeatable systems, formal and informal, that reinforce operational excellence. Developing a culture of support and gratitude for one another starts with you popping in consistently to thank people for hard work and credible expertise that you can count on.

In closing…

Pull your leadership team together. Let them know that you expect praise to be free flowing across every layer of the organization. Together commit to promoting a recognition-rich culture.