High-reliability principles (eg, preoccupation with failure, reluctance to simplify, sensitivity to operations, commitment to resilience, deference to expertise), when applied in high-risk clinical environments like the OR, can lead to safer practices, fewer errors, and processes that prevent errors that do occur from reaching the patient and causing harm. Enterprise risk management proactively addresses both risks of loss and opportunities for gain. It is a framework that risk managers can apply across disciplinary lines indeed, across the health care enterprised to identify, analyze, and treat risks to patients, operations, employees, and technologies. Application of this framework allows risk managers to keep within legal and regulatory requirements while pursuing the financial objectives and the strategic mission of the organization.45 There is congruence between the principles of high- reliability organizations and the processes of enterprise risk management when they are applied with the common goal of protecting the patient and the organization.
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