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The Joint Commission Center for Transforming Healthcare recently made available the Oro 2.0 High Reliability Organizational Assessment. The assessment is an online tool designed to assist hospitals in evaluating their progress toward high reliability and support them in attaining the goal of zero patient harm. The web-based tool is available to accredited organizations on their Joint Commission Connect extranet site. The Oro 2.0 Assessment guides the leadership team through a series of questions on key strategic performance issues. It’s based on the High Reliability Maturity Model which emphasizes:

  • Leadership commitment to achieving zero patient harm
  • A fully functional Safety Culture
  • Widespread deployment of Robust Process Improvement tools

The goal of conducting the assessment is to identify areas in which the leadership team needs to make improvements in order to become a High Reliability Organization. Once the assessment is completed, a report is generated identifying strengths and opportunities for improvement. Based on the results of the assessment, the user is guided toward resources available in the Oro 2.0 Resource Library.

Examples of the questions are as follows:


How would you describe your organization’s overall approach to quality and patient safety?

  1. Our programs are designed primarily to comply with the requirements of outside entities (e.g., CMS, Joint Commission, state government).
  2. Our programs are currently designed primarily to address regulatory requirements, but we are beginning to set our own goals.
  3. Our programs address regulatory requirements and are also designed to achieve goals that are set by our own organization.



How would you describe the frequency with which physicians lead quality improvement initiatives organization-wide, when appropriate, and in each department, clinical and operational?
  1. Rarely or never
  2. Sometimes
  3. Often
  4. Routinely



The recommended method for completing the assessment is to first have senior leaders complete it individually and then have them meet as a team and complete one final assessment for the hospital by consensus. Recommended participants are CEO, CNO, CMO, COO, CFO, Chief Clinical Officer, Board Chair (or chair of Board Quality Committee), Patient Safety Officer, VP for PI, and Risk Management leader. The ideal group size is no more than 15 to allow for in-depth discussion and high level perspective.

After completing the assessment, the next step, of course, is acting on the results. Based on the strengths and opportunities identified, the leadership team should identify areas for strategic direction and develop a solid action plan. The schematic below summarizes the process.

[lightbox alignment=”aligncenter” type=”image” image=”/wp-content/uploads/action-plan.png” thumbnail=”/wp-content/uploads/action-plan-1024×240.png” title=”Oro 2.0 High Reliability Organizational Assessment process.”]Oro 2.0 High Reliability Organizational Assessment process.[/lightbox]

So, if you are looking for a tool to initiate or bolster your hospital’s high reliability journey, check out Oro 2.0. It provides a great opportunity to engage the leadership team in an analysis of its approach to quality and patient safety. In addition, as we know, the topic of high reliability has been a prominent part of the leadership interview during hospital surveys for the past two years. That discussion typically has focused on determining if hospital leadership was familiar with the concept of high reliability. The new Oro 2.0 Assessment now presents an opportunity to demonstrate that leadership has moved beyond awareness of this approach and into evaluation and action planning.

For more information, see the Facts about Oro 2.0 High Reliability Organizational Assessment. To learn more about how we can help, check out our Patient Safety Consultation services.