Leadership Engagement for Military Hospitals: A Case Study of the Effects of Executive Leader Engagement in Military Hospitals That Have Become High Reliability Organizations

Purpose: The purpose of this qualitative case study was to explore and explain the leadership strategies that military hospital executive leaders used to engage hospital staff in implementing the six principles of High Reliability Organizations (HROs). Methodology: A qualitative case study approach was selected for this study. Interviews were conducted with three executive leaders describing their experiences with initiating and managing the change development of HRO. The participants in this study were executive leaders of military hospitals across the Puget Sound Military Health System. All participants had direct experience with the implementation of HRO. Interview transcripts were analyzed and reviewed for themes and trends. Findings: Examination of the study data from military hospital executive leaders participating in this study indicated that executive leaders used similar strategies to implement the six HRO principles. Strategies that promoted the HRO principles of preoccupation with failure, commitment to resiliency, sensitivity to operations, deference to expertise, reluctance to accept simple explanations for problems, and creating a strong safety culture were identified as being helpful and engaging of staff with the implementation of HRO. Conclusions: There were four conclusions drawn from this study based on the data. The results of this study support the conclusion that reveals executive leaders used strategies that helped them engage staff in implementing all six HRO principles, and finding the right strategies for leaders to use is certainly dependent on resources available. Recommendations: Further research recommendations include (a) exploring how first line leaders implement and maintain an HRO within military hospitals, (b) exploring how executive leaders implement and maintain an HRO within a similar military healthcare system of hospitals, (c) exploring a comparison study between military hospitals and civilian hospitals, (d) examining the lived experiences and perceptions of leaders who have worked in both hospitals that have implemented HROs and hospitals that have not, (e) replicating this study focusing on only one of the military hospitals in the Puget Sound Military Health System, (f) examining the lived experiences and perceptions of leaders who have worked in both hospitals that have implemented HROs and other industries that have implemented HROs