Achieving the status “High Reliability Organization (HRO)” is now the gold standard for healthcare organizations, but there is little agreement on how to achieve it. To help you move your organization toward this important goal, let’s try to make that term clearer. Authors Weick and Sutcliffe first used the phrase in their 2001 book, Managing the Unexpected, now in its 3rd revision (Weick, K. E., & Sutcliffe, K. M., 2015 Managing the unexpected, John Wiley & Sons).