Dating the early hro
When I became a physician in the Pediatric Intensive Care Unit (PICU) I had a chance to apply my mountaineering and LAFD Rescue Ambulance experiences to medical care and teaching. We also had half the expected mortality for a unit of our size and for an academic center.We used this approach in in our regional EMS program and an investigative reporter spent three months looking for problems in our pediatric EMS program. These results gained the notice of Karlene Roberts, Ph D, from the University of California, Berkeley, who told me that we were performing in a manner she called High Reliability and that we had created a High Reliability Organization (HRO).
When I began teaching in the PICU I wanted to help students, residents, respiratory care practitioners (RCP), and nurses by teaching them what we really do.
This started our collaboration with the Berkeley group of HRO academics [ and our series of HRO articles. Early on I was taught that people are our best assets, particularly when a problem must be solved immediately because of high risk.