ABSTRACT
This chapter provides a discussion of how organizations can carefully plan, implement, measure, and spread improvements based on their organizational culture, environment, and strategies. Some organizations have established just culture policies to ensure staff protection. High reliability organizations (HROs) are characterized by complex systems with high workloads and pressures. These organizations have mastered the ability to adapt and respond to unexpected events while delivering reliable and safe outcomes. HROs increase employee engagement, which ultimately improves and enhances patient care, satisfaction, and financial performance. HROs put themselves in a position to see the notes as much as possible, welcome diversity, and be prepared to react. HROs systematically spread and scale up changes in practice that demonstrate improvement. Successful spread and scale-up requires an understanding of some of the key challenges; therefore, having a systematic framework that supports preparation, development, and execution of spread plans is an excellent way to overcome challenges.
