In 1846, physicians at Vienna General Hospital were killing one in ten mothers during childbirth. Not through malpractice—through handshakes. They conducted autopsies in the morning, delivered babies in the afternoon, and carried childbed fever between the two. When Ignatz Semmelweis recommended hand-washing, the medical community's response was predictable: rejection, ridicule, institutionalization. He died at forty-seven, possibly from the very disease he'd tried to prevent.
The parallel to high reliability efforts today is uncomfortable. Organizations invest heavily in HRO principles—preoccupation with failure, sensitivity to operations, reluctance to simplify, deference to expertise, commitment to resilience. They train behaviors, create checklists, conduct Gemba walks. And yet the transformation stalls. Why?
Because you can't solve a mindset problem with a behavioral solution.
When employees rate their organizations a 4.6 on mindset but rate themselves a 6.8, they're saying: "I'm not the one who needs to change." Just like those Vienna physicians couldn't fathom that they were carrying the disease, today's healthcare professionals—and professionals in any complex industry—struggle to see their own contribution to the problems they're trying to solve.
This webinar connects mindset directly to psychological safety, the foundation of high reliability. When I'm inward, I see colleagues as vehicles, obstacles, or irrelevancies. That objectification invites resistance, creates collusion, and destroys the very psychological safety that allows people to speak up about errors. The result: silence benefits me immediately and certainly; speaking up benefits the organization later and uncertainly. So people stay silent.
The solution isn't more training. It's different training—starting with mindset, then watching behaviors follow.
Learning Objectives
- Connect mindset to high reliability—understand why behavioral and policy solutions alone cannot create a culture of safety
- Recognize the self-deception gap as the obstacle to change—"I'm not the one who needs to change"
- Distinguish compliance from commitment—and understand why commitment is essential to HRO
- Apply SAM to operationalize HRO principles in everyday interactions, not just formal Gemba walks
- Understand collusion dynamics and how inward mindsets create the very conflicts we complain about
