High Reliability in Health Care is Possible 

High reliability means consistent excellence in quality and safety across all services maintained over long periods of time. This high level of performance, which includes the elimination of major quality failures, does not exist in health care today.

Based on its knowledge of health care and through studying the features of industries that have achieved high reliability, The Joint Commission uses a framework that health care organizations can use to accelerate their progress toward the ultimate goal of zero harm. The framework is organized around three major domains of change:

1. Leadership committed to the goal of zero harm.
2. An organizational safety culture where all staff can speak up about things that would negatively impact the organization.
3. An empowered work force that employs RPI tools to address the improvement opportunities they find and drive significant and lasting change.