High-Reliability Training and Collaborative Just Culture

As a high-reliability health care organization, Tampa General Hospital is committed to providing safe, reliable and effective patient care. To do so, we must create and sustain a culture that is focused on preventing errors and minimizing harm. This is vital because we continually operate in complex, high-risk and high-hazard situations. While under tight time constraints, our team must utilize advanced technologies, operate at high capacity and face ever-changing regulatory pressures.

In light of the myriad challenges we face, TGH strives to achieve error-free performance and safety in everything we do. To maintain this high standard, we must seek robust process improvements and have the full commitment of every team member. To that end, TGH has become the first hospital in the country to achieve qualifications for our Collaborative Just Culture Program® and High Reliability Management Team™ from DNV, a global independent certification, assurance and risk management provider. These two key qualifications put us closer to certification as a Collaborative High Reliability Organization®.

With this goal in mind, we confidently shape our culture around a journey toward zero harm and offer high-reliability and collaborative just culture training for our leaders.

Key tenets of our program include:


We need to be mindful of our day-to-day operations and provide our team members with the resources and abilities they need to respond quickly and appropriately to dynamic situations when caring for our patients. In other words, moving away from a punitive mindset allows us to instead focus on system processes that may lead to human behavior. By decentralizing our decision-making processes, we can empower our team members to identify and report potential errors and develop strategies to prevent or mitigate their consequences. Additionally, we want to see and understand risk in a different way—so we can identify risk before an event happens.


At every level of our organization, we must reduce variation by designing and implementing processes that are predictable, consistent and repeatable. We must also ensure that all team members are properly trained to follow the same protocols and procedures and that everyone is working toward the same goals. Through consistency, we can reduce the risk of errors and improve our patient outcomes.


We recognize that unexpected events can and will occur, and we must continue to function when they do. To foster resilience, we help our team members learn how to respond to unanticipated situations quickly and appropriately. After resolving an issue, we regroup and learn from the experience, taking into account our individual and collective performance while identifying ways to improve.

By providing high-reliability and collaborative just culture training, TGH helps to ensure that vigilance, mindfulness and continual improvement are everyone's responsibility as we collectively pursue zero harm.