¹J.L. Himali R. Wijegunasekara,² G. Sudath K. Dharmarathe

¹,²Ministry of Health, Sri Lanka.

Introduction:
“High Reliability Organizations (HRO)” is an innovative safety management concept. An effort to transform a health care setting in Sri Lanka to a HRO – management structure is worthwhile to experience the outcomes of this model in Sri Lankan hospital context. Objective: To establish a HRO - management structure in the Neonatal Intensive Care Unit of De Soyza Maternity Hospital Colombo.
Design:
Pre / post interventional study design was used. Functional status of HRO structure in the NICU was assessed; using 5 HRO principles (ie. Pre occupation with failure, Resistance to simplify, Sensitivity to operations, Commitment to resilience and Deference to expertise) and 5 HRO elements (ie. Process auditing, Rewarding, Avoidance of quality degradation, Risk perception, and Command and control), at pre and post interventional levels.
Methods:
Practice of HRO principles was assessed using a Self - Administered Questionnaire with a rating scale, with the participation of all the NICU staff. Practice of HRO elements was assessed by a facility survey using a check list. Intervention consisted of a managerial plan with activities to establish the HRO concept. Results:
Results showed a statistically significant increase of “response scores” of participants towards HRO structure and the facility survey showed the establishment of planned activities.
Conclusion:
It was concluded that implementation of this plan, is gradually establishing the HRO management structure in NICU of DMH.

High Reliability Organizations, Neonatal Intensive Care Units.

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