Struggling to invent high-reliability organizations in health care settings: insights from the field.

The Agency for Healthcare Research & Quality (AHRQ) conducted interviews with senior staff members at eight health systems regarding implementation of patient safety initiatives. The goal of the interviews was to identify organizational needs when implementing patient safety efforts and summarize ongoing efforts. Although all organizations had many culture-, technology-, and system-focused patient safety projects under way, most had begun only recently. All organizations reported difficulty in implementing initiatives, primarily due to lack of a mechanism for learning from other successful health care systems. AHRQ plans to develop a learning network to facilitate dissemination of effective implementation strategies among health systems.