HRO: (1) God as Highly Reliable

As a member of a healthcare institution, I’ve become increasingly familiar with the concept of “high reliability organizations”—something that healthcare is not.  High reliability organizations (HROs) are those organizations which consistently demonstrate safe, predictable, optimal outcomes despite operating in complex, fast-moving, unpredictable environments.  Nuclear power and commercial air travel are often cited among the few examples of successful HROs.  Weick and Sutcliffe are frequentlycited as the genesis for this concept in their book "Managing the Unexpected: Resilient Performance in an age of Uncertainty."  My musings are also based on an article by Chassen and Loeb.

I teach about HROs and patient safety in my hospital, training new employees on principles that will hopefully result in zero events of preventable patient harm.  I am about to embark in a leadership role in our hospital safety program.  I thought it would be edifying for me to run these concepts through the sieve of God’s word, filtering for those concepts which line up with God’s wisdom.  Every truth comes from God, and therefore I expect to find echoes—and even shouts—of these principles in scripture.  My goal is to simultaneously study God’s word and the principles of HROs for healthcare, to gain a greater understanding of both.

HRO’s are predictable, consistent, reliable…to an extent, these are words I would use to describe God.  He is immutable and unchanging, operating perfectly in a complex and constantly changing world.  Are HRO’s going to attain the perfect reliability of God?  No.  Can human institutions seeking to become reliable learn from God’s perfect example?  Yes, I believe so.  

Deuteronomy 7: 9-11 states that “…He is the faithful God, keeping His covenant of love to a thousand generations of those who love Him and keep His commands….[b]ut those who hate Him He will repay to their face by destruction.”  God’s covenant of faithfulness relies upon obedience, at least according to these verses.  Deuteronomy 32 is a final psalm of praise by Moses right before his death.  God is repeatedly described as a Rock, “Oh, praise the greatness of our God!  He is the Rock, His works are perfect, and all His ways are just.  A faithful God who does no wrong, upright and just is He.” The story of Israel’s unfaithfulness is woven together with the story of God’s demands for faithfulness from His people while He demonstrates what true faithfulness looks like:  it is a pattern of God’s blessing, His people forsaking Him and receiving the consequences of rejecting Him, followed by God’s mercy, forgiveness and reconciliation.  

In 2 Timothy 2: 12-13, we are told “…If we disown Him, He will also disown us; if we are faithless, He will remain faithful for He cannot disown Himself.”  God’s faithfulness is an intrinsic, inseparable component of His nature.  The disobedient and sinful cannot stand in the presence of a holy God, but God will always remain faithful to His nature and His promises.  

In the words of the hymn by Thomas Chisolm, “Great is thy faithfulness, O God my Father, there is no shadow of turning with Thee; Thou changes not, Thy compassions they fail not, as Thou hast been Thou forever wilt be.”  This hymn is based upon Lamentations 3:22-23, which says “Because of the Lord’s great love we are not consumed, for His compassions never fail.  They are new every morning; great is your faithfulness.”   We have a faithful God, one who is both holy and loving, perfect and full of mercy.  God’s character does not change; we can depend upon Him.  

1)      God is faithful and constant.  He is our Rock.  How can you emulate God’s faithfulness and constancy in your role as a leader?

2)      What in your organization must be completely solid, reliable and constant?  What are the implications of failure?

3)      How can you bring the constancy of God into the parts of your organization that demand high reliability?  Is it possible to weave together the spiritual and the secular in this way?

4)      God’s nature is both holy and loving.  He does not tolerate sin but is also merciful and forgiving toward the repentant.  How can you bring God’s forgiveness and mercy into your workplace?  Will incorporating mercy “water down” the demands of becoming a high reliability organization, or is there room for both of these concepts in the workplace?

  

Image credits for HRO photo series: 

Source:  https://visualsonline.cancer.gov/details.cfm?imageid=11327, the National Cancer Institute (NCI); photo depicts Dr Stephanie Goff, cancer researcher, along with seven colleagues in an operating room at the National Institute of Health.  Photograph taken by Jeremy Davis, modified by the author using the iPhone application “Picsart” and a glass of wine.