Believe it or not! Quality does not happen by accident. We must make an intentional effort to measure, assess, and improve performance. Not only must an organization's board of trustees and senior management be committed to quality but they also must create a framework for accomplishing quality activities and an environment that supports continuous improvement. Lead by example! Active and personal board involvement in quality and patient safety oversight contributes to building a high-performing healthcare organization. In our organization we are striving to become a Highly Reliable Organization. How are you becoming a HRO?

While there is no "correct" culture. A culture that works in one organization may not work in another. A culture's suitability depends on how well it supports the organization's quality management goals. Is the culture at your facility undermining quality improvement efforts? What are some red flags that signal incompatibility between the culture and organization?