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Sigma in the news   

Experts offer high reliability organization principles for healthcare facilities

New STTI book bridges the gap between theory and practice to improve quality outcomes and patient safety

Julie Adams, Director, Marketing and Communications
Honor Society of Nursing, Sigma Theta Tau International 

INDIANAPOLIS — Although often discussed, high reliability methods and science have still not been totally implemented into healthcare culture. Nurses, representing the majority of healthcare workers, are on the front line of the delivery and provision of safe and effective care and are ideally situated to drive the mission to achieve high reliability in healthcare.

In High Reliability Organizations, authors Cynthia Oster, PhD, MBA, APRN, CNS-BC, ANP and Jane Braaten, PhD, APRN, CNS, ANP, CPPS present practical, real-world examples of high reliability organization (HRO) principles in order to establish a system that detects and prevents errors from happening even in the most difficult, high-risk conditions. 

By emphasizing system fixes, rather than individual fixes, High Reliability Organizations provides nurses and other healthcare professionals with tools and practical applications, resulting in an improvement of patient safety and quality outcomes.

“It’s important that healthcare organizations look for the root cause of a problem and not just the symptom,” Oster said. “By utilizing HRO principles, we can flip the paradigm in healthcare to proactivity to prevent events rather than reactivity when events occur.”

The book is available at

High Reliability Organizations: A Healthcare Handbook for Patient Safety & Quality
By Cynthia Oster, PhD, MBA, APRN, CNS-BC, ANP and Jane Braaten, PhD, APRN, CNS, ANP, CPPS
Published by STTI, 2016
ISBN-13: 9781940446387
EPUB ISBN: 9781940446394
PDF ISBN: 9781940446400
MOBI ISBN: 9781940446417
Price: US $64.95
Trade paperback, 544 pages
Trim size: 8 x 10

About the authors

Cynthia A. Oster, PhD, MBA, APRN, ACNS-BC, ANP, is a nurse scientist and clinical nurse specialist for critical care and cardiovascular services at Centura Health, Porter Adventist Hospital in Denver, Colorado. She has 35 years of experience in nursing as a registered nurse, with employment in a variety of clinical, research, educational, and administrative roles. As a mentor of novice researchers, she facilitates the conduct of research, and facilitates the adoption of evidence-based practices in Centura Health. Oster is the principal investigator of several ongoing research studies in Centura Health and chairs the South Denver Evidence-Based Practice, Research and Innovation Council. 

Jane S. Braaten, PhD, APRN, CNS, ANP, CPPS, is a patient safety manager and nurse scientist at Centura Health. She has held positions within Centura Health as director of cardiology services, cardiac and intensive care clinical nurse specialist, cardiac nurse practitioner, and manager/charge RN/staff RN of intensive care and telemetry units. She has presented at national meetings and has published in the areas of hospital system barriers to rapid response team activation, quality improvement in telemetry, end-of-life care in the intensive care unit, leadership, and high reliability organizations and healthcare.


The Honor Society of Nursing, Sigma Theta Tau International (STTI) is a nonprofit organization whose mission is advancing world health and celebrating nursing excellence in scholarship, leadership, and service. Founded in 1922, STTI has more than 135,000 active members in more than 90 countries. Members include practicing nurses, instructors, researchers, policymakers, entrepreneurs and others. STTI’s roughly 500 chapters are located at approximately 700 institutions of higher education throughout Armenia, Australia, Botswana, Brazil, Canada, Colombia, England, Ghana, Hong Kong, Japan, Kenya, Lebanon, Malawi, Mexico, the Netherlands, Pakistan, Portugal, Singapore, South Africa, South Korea, Swaziland, Sweden, Taiwan, Tanzania, Thailand, the United States, and Wales. More information about STTI can be found online at