Reliability between nurse managers: the key to the high-reliability organization.

Flawless execution rests in the hands of nurse managers. No one can work alone in health care any more. We are interdependent and know that the best outcomes happen when practices are organized around collegial supportive structures rather than autonomous competitive units. We are only as strong as our weakest link. If all managers see the big picture and look beyond their units for what is right for the common good, we will achieve high-reliability organizations in health care. In turn health care organizations will become very safe places to operate. Shared governance structures for nurse managers are the perfect vehicle to develop collaborative organizations and flawless execution, and to adopt high-reliability organization principles.