Risk management has become a key ingredient for businesses all over the world. High Reliability Organizations (HRO) has distinguished themselves as experts in this area. By continuously focusing on improving their ability to manage risks they’ve been able to successfully avoid catastrophes in environments where normal accidents can be expected due to complexity and risk factors.The aim of the thesis is to improve the risk management at Apotekens Service by applying theories from HRO and safety culture. In July 2009, following the re-regulation of the Swedish pharmacy market, Apotekens Service AB was appointed national pharmacy infrastructure supplier for the Swedish health care system. The market's direction and scope gives rise to a complex socio- technical environment that places high demands on the company's risk handling activities. By mapping the principles behind the success of HROs against methods used today, the thesis develops a foundation for how companies like Apotekens Service can manage risk efficiently.The analysis shows that there are great opportunities for Apotekens Service to apply theories of HRO and safety culture to improve their risk management.The company already has a positive safety culture, which is a prerequisite for maintaining safety over time. By mapping out the organization’s internal system dependencies, perform a threat analysis and develop an effective information management system Apotekens Service will improve the internal transparency whilst strengthening the possibilities for learning and effective communication. Finally, the thesis presents three risk management tools for assessing risk and reviewing the company’s ongoing work in the area.

Bakgrund Storstockholms brandförsvar (SSBF) har sedan bildandet 2009 arbetat mot en mer kostnadseffektiv organisation. Detta är ett relativt nytt sätt att tänka inom räddningstjänsten. Denna typ av organisationer har traditionellt sett opererat utan kostnadsfokus. För att beskriva räddningstjänsten organisatoriskt har vi använt oss av teoribildningen kring high reliability organizations (HROs), organisationer som alltid sätter säkerheten först. Arbetet mot en kostnadseffektivare organisation beskriver vi i termer av new public management (NPM) och lean production (Lean). Mellan dessa teoribildningar, HRO, NPM och Lean finner vi motsättningar där HRO traditionellt sett arbetar med överkapacitet för att alltid vara redo om olyckor skulle inträffa. Denna överkapacitet betraktas inom NPM och Lean som resursspill vilka skall elimineras för att få till en kostnadseffektivare organisation.   Syfte Att genom en fallstudie av SSBFs förändringsarbete beskriva och förstå vilka effekter tillämpandet av Lean production får i en High Reliability Organization.   Metod Vi har använt oss av en kvalitativ fallstudie. Genom intervjuer har vi kartlagt anställda inom SSBFs tankar om kostnadseffektivitet och dess påverkan på den egna organisationen.   Slutsatser Kostnadsbesparingarna i budgeten och sättet dessa genomförs på ser vi som ett tydligt tecken på influenser av New Public Management och Lean production. Vi ser den minskade redundansen som en risk för säkerheten, både för de anställda men också allmänheten. Vi anser också att det har lett till en effektivare resursanvändning, dock bör kommunikationen förbättras och en dialog föras mellan de lokalt och centralt anställda för att hitta lösningar som påverkar säkerheten i så liten utsträckning som möjligt.

Les théories portant sur l'analyse stratégique, sur l’alignement et les configurations organisationnelles ne suffisent plus aux entreprises pour garantir leur pérennité dans des environnements devenus de plus en plus tumultueux. Aux compétences d’anticipation doivent à présent s’ajouter des facultés nouvelles d'adaptation. Les travaux de Weick K.E. portant sur les organisations hautement fiables (HRO : High Reliability Organization) et d’autres traitant du management de crise nous ont permis d’identifier le concept de résilience organisationnelle. De manière générique, la résilience est ce qui permet à un système de ne pas disparaître suite à un choc grave et de rebondir parfois pour se développer à nouveau. Nous avons défini la résilience organisationnelle de manière théorique comme la manifestation lors d’une crise traumatique d’un ou plusieurs des processus : de la résilience psychologique individuelle, de la résilience collective ou de la résilience écoenvironnementale. Ces processus, lorsqu’ils se manifestent, permettent à l’entreprise de survivre à la crise et de ne pas disparaître. / Theories on strategic analysis, alignment and organizational configurations are no longer sufficient for companies to ensure their survival. Environments become more and more turbulent. Skills of anticipation are not good enough now, companies need also adaptability. Research works from Weick K.E. on the HRO (High Reliability Organizations) and from other authors who work on crisis management have enabled us to identify the concept of organizational resilience. Resilience is usually defined as the properties of a system able to sustain a severe shock, to bounce and to grow again. We defined organizational resilience as the manifestation, during a traumatic crisis, of one or more of these three processes: individual psychological resilience process, collective resilience or eco environmental resilience. These processes when they occur, allow the company to survive to the crisis.

Titel: Att omsätta kunskap i handling - En kvalitativ studie av organisatoriska lärandeaspekterNivå: Kandidatuppsats i Ledarskap och OrganisationFörfattare: Jessica Sääf och Alexandra RidellUtgivningsår: Ht 2011Handledare: Anders Edvik och Charlotte PeterssonProblemområde: Det finns en problematik i att enas om vad begreppet organisatoriskt lärande innebär. Samtidigt tycks det finnas en enighet kring att organisationer bör anpassa sig till och eftersträva organisatoriskt lärande. I denna studie vill vi belysa begreppets komplexitet när det undersöks i en organisatorisk verklighet.Metod: En studie har genomförts i en högrisk organisation (HRO) där nio personer intervjuats. Intervjuerna har baserats på litteratur och forskning om den organisatoriska lärandeprocessens nyckelaspekter. Det empiriska materialet har analyserats utifrån de nyckelbegrepp som framkom i intervjuerna; handlingsutrymme och förändringsbenägenhet (avseende rutiner).Resultat: Vår studie visar att begreppen handlingsutrymme och förändringsbenägenhet (avseende rutiner) förstås utifrån den organisatoriska kontexten. Det innebär därmed att lärande bör relateras till det sammanhang inom vilket det skall uppstå.Vidare forskning: Studera den organisatoriska strukturens betydelse för lärande i högrisk organisationer.Uppsatsens bidrag: Studien bidrar till en nyanserad bild av begreppet organisatoriskt lärande, dess villkor och premisser.Nyckelord: Organisatoriskt lärande, handlingsutrymme, förändringsbenägenhet, HRO, säkerhetskultur. / Title: Turning knowledge into action - A qualitative study of organizational learning aspects Level: Bachelor in Leadership and organization Authors: Jessica Sääf and Alexandra Ridell Release: Autumn 2011 Advisors: Anders Edvik and Charlotte Petersson Problem: Amongst the research collective there exists a difficulty in agreeing on what the concept of organizational learning actually involves. At the same time there seems to be a consensus that organizations should adapt and pursue organizational learning. In this study, we aim to highlight the concept's complexity when it is examined in an organizational reality. Method: The study was conducted in a high risk organizations (HRO) in which nine people were interviewed. The interviews were based on literature and research on key aspects of the organizational learning process. The empirical data have been analyzed according to the key concepts that emerged from the interviews, flexibility and willingness to change (refers to change of practice and procedures). Result: Our study shows that the concepts of flexibility and willingness to change (procedures) are understood in terms of the organizational context. This thus means that organizational learning should be related to the context in which it is to be realized. Further research: Study the effect organizational structure has on learning in high-risk organizations. Contributions: The study contributes to a nuanced picture of the concept of organizational learning, its conditions and premises. Key words: Organizational learning, flexibility, willingness to change, HRO, safety culture.

Les services d’incendie et de secours français, collectivités territoriales touchées par capillarité par les logiques de résultats instituées par la LOLF en 2001, sont aujourd’hui au cœur de multiples injonctions en termes d’efficience et d’efficacité. Leur fiabilité organisationnelle devient un enjeu central que nous pensons être en interrelation avec les logiques d’utilisation des outils de technologie de l’information, tels que ceux déployés dans le domaine de l’aide à la décision. Nous explorons dans ce travail la fiabilité organisationnelle sous le prisme de la théorie des HRO en la rapprochant de la littérature sur les systèmes d’information. Encapsulée dans un constructivisme téléologique et projectif, cette thèse présente une recherche-intervention visant à déployer de tels outils informationnels au SDIS des Bouches du Rhône dans une optique de fiabilisation de leurs activités. Accompagnée d’une observation participante et de la tenue d’un journal de bord, cette recherche-intervention a été conclue par une série d’entretiens semi-directifs avec les acteurs de l’organisation. Les résultats font l’objet d’interprétations mettant en évidence les impacts des outils informationnels sur la fiabilité du SDIS des Bouches du Rhône. Une discussion a permis de faire émerger des préconisations à destination des praticiens sous la forme de recommandations et de représentations liées à l’implémentation d’un management par les processus. Parmi ces propositions, nous présentons un modèle de maturité de l’organisation à devoir de fiabilité afin de guider les organisations publiques dans l’évaluation de leurs capacités en termes de fiabilisation de leurs activités / For three decades, the French firefighters have come to know many legal and organizational disruptions that have led to several obligations in terms of accountability and efficiency. These injunctions brought forward the question of their organizational reliability as a core issue that cannot be isolated from the emergence of new technologies and their contribution to decision-making in organizations. In this thesis, we explore organizational reliability through the lens of the High Reliability Organizations theory while combining it with information systems literature.Integrated in a teleological and projective constructivism, this thesis presents a specific action-research aimed for an implementation of informational tools in the Fire Department of the Bouches du Rhône (France) with the expectation to contribute to a better reliability of its activities. After a three-year long participant observation and a research logbook, we concluded this action-research with a succession of interviews conducted with the actors of the organization. At the end of the thesis, we interpret the results produced by the analysis of this primary and secondary data to highlight the influence of informational tools on the reliability of the Fire Department studied. A discussion enables us to formulate recommendations and models bound for practitioners and related to the implementation of a business process management. Among these suggestions, we propose a maturity model of organizations concerned by a “duty of reliability” in order to guide public organizations in the evaluation of their capacities regarding the reliability of their activities

There are certain organizations that manage to handle risk in such a successful way that they almost stay error-free, in spite of the fact that they daily face the risks of accidents. These organizations are usually given the name High Reliability Organizations (HRO). While the most common example is that of a nuclear plant the variety of what organizations can fit into the category is extensive. The purpose of this study is to describe safety culture and theories about HRO and how these can be found in practise within an organization. This qualitative research uses influences of ethnography in its method. The ethnographical approach was picked due to the field of the study and the cultural context in which it is set. The results of the study identify a number of elements sorted into four themes. These themes are deemed compatible or non-compatible with relevant existing theories. While most of the results match, the issue of routine-based work is not coherent with leading theories of HRO. An effort in making an alternative explanation proposing a balance between routines and mindfulness is taken on the subject.

<p>There are certain organizations that manage to handle risk in such a successful way that they almost stay error-free, in spite of the fact that they daily face the risks of accidents. These organizations are usually given the name High Reliability Organizations (HRO). While the most common example is that of a nuclear plant the variety of what organizations can fit into the category is extensive.</p><p>The purpose of this study is to describe safety culture and theories about HRO and how these can be found in practise within an organization.</p><p>This qualitative research uses influences of ethnography in its method. The ethnographical approach was picked due to the field of the study and the cultural context in which it is set.</p><p>The results of the study identify a number of elements sorted into four themes. These themes are deemed compatible or non-compatible with relevant existing theories. While most of the results match, the issue of routine-based work is not coherent with leading theories of HRO. An effort in making an alternative explanation proposing a balance between routines and mindfulness is taken on the subject.</p>

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Thesis advisor: Judith Vessey / Purpose: The purpose of this study was to explore the relationships between psychological safety, perception of working in a high reliability organization (HRO) and safety event reporting intentions among pediatric nurses working in acute care. Background: The quality and safety of patient care is dependent upon nurses to report safety events and near-misses in order to address systems’ issues and identify improvement opportunities. To encourage feedback and promote reporting, many health care organizations have adopted the high reliability framework and strategies to promote team psychological safety. A dearth of literature exists on how the pediatric nurse perceives their workplace. This study addressed this gap by measuring the pediatric nurse’s level of psychological safety, perception of whether or not they work in an HRO and their safety event reporting intentions. Methods: Using nonprobability convenience sampling, data were collected from pediatric nurses (N=244) during a one-time, anonymous, 10-minute web-based survey. The survey was distributed to members of the Society of Pediatric Nurses (SPN) and by members of the National Pediatric Nurse Scientist Collaborative (NPNSC) to their respective constituent groups. The online survey comprised of four sections: a demographic form, the Safety Organizing Scale (SOS), the Team Psychological Safety Scale, and the Intention to Report Safety Events Scale. A two-part statistical model was fit using logistic regression and linear regression. Results: Psychological safety was found to have a positive and statistically significant relationship with Intention to Report Safety Events Scores (p<0.01; β=0.274). The findings also revealed that when all other variables were excluded from the statistical model, a positive and statistically significant relationship between HRO perception and safety event reporting intentions (p=0.034) existed. The logistic regression model revealed that the odds of a pediatric nurse achieving the highest safety reporting intention score of 7 increased by a factor of 0.3 with each additional year of practice. Conclusions: The findings demonstrated that a nurse’s perception of whether they work in a high reliability setting and how psychologically safe they feel profoundly effects their attitude towards safety event reporting. This work advances the state of the science by demonstrating how workplace culture, and specifically psychological safety and the HRO framework, influences reporting intentions. The information gained from this study will be useful to organizational leaders and professional groups who seek to improve patient safety reporting systems, communication strategies and existing workplace cultures. / Thesis (PhD) — Boston College, 2022. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Companies can draw valuable lessons from their failures, and use them for their improvementwork. A positive failure culture is however a necessary precondition. High reliabilityorganisations (HRO) are known for their effective way of tackling and using failures aspotential for improvements. The aims of the study were to evaluate failure culture in an ISO9001 certified company, after HRO standards and thereby withdraw improvementpossibilities. The study was conducted through a deductive quantitative method using asurvey for data gathering. With approximately 30 percent response rate, and using statisticaltests, the failure culture of the company was evaluated. The results showed that the companyis not currently reaching a failure culture within HRO standards, but nevertheless has positivetendencies rather than negative. Lastly, improvement possibilities were discussed andsuggestions for further research were given. / <p>2020-06-26</p>