For Every Patient: How High Reliability Is Powering Gains in Quality at Mass General Brigham
Across Mass General Brigham, a familiar scene is playing out in inpatient units, emergency departments and ambulatory practices alike: care teams gathering around shared data, openly discussing risks, and working together to improve care for every patient.
These structured, candid and action-oriented conversations are at the heart of Mass General Brigham’s transformation into a High Reliability Organization (HRO).
That transformation recently reached an important milestone. With the launch of HRO quality rounds on its 100th unit, Mass General Brigham has scaled a model that is reshaping how teams across the system identify risk, solve problems and deliver safer, higher-quality care.
Heart and Vascular Institute leaders share how the system's quality strategy is driving improvements in patient care and access.
Measurable progress, systemwide
Guided by the system’s For Every Patient unified quality strategy, clinical teams are achieving measurable gains in performance, through new approaches grounded in high reliability principles.
As of the latest reporting period, Vizient data show that Brigham and Women’s Hospital now ranks in the top 20 hospitals nationally on overall quality and ranks 4th out of 122 academic medical centers for mortality. Massachusetts General Hospital continues to perform at a high level, ranking 15th out of 122 for mortality. With half the reporting year to go, Mass General Brigham is on track to meet our system goal for quality this year, with our Vizient composite score of 62 currently about 4 points higher than our target of 58.
These improvements reflect a consistent trend: as more units adopt the structures and behaviors of high reliability, outcomes are improving.
HRO: The engine driving performance improvement
HRO quality rounds are not simply meetings, they are the foundational elements of the operating system for our transformation. And they connect to a broader systemwide structure that will drive sustained improvements against clinical goals, through clinician-led decision-making and bidirectional accountability between frontline teams and leadership.
Launched in late 2024 in six Heart and Vascular Institute units, HRO rounds have rapidly expanded to include dozens of inpatient units and most of the system’s emergency departments across the system’s academic medical centers and community hospitals, as well as a growing number of ambulatory practices. Today, nearly half of Mass General Brigham’s inpatient beds are on units where these rounds are embedded into routine care.
Every other week, frontline teams come together to review unit-specific data, identify risks and co-design solutions. The approach emphasizes transparency, psychological safety and shared accountability—hallmarks of high-reliability organizations in industries where safety is critical.
This structure enables teams to move quickly from insight to action—and to spread what works.
“High reliability is how our clinical teams are turning data into better care at the bedside,” said Patrick Ellinor, MD, PhD, Executive Director, Mass General Brigham Heart and Vascular Institute. “By creating a consistent, systemwide approach to identifying risk and solving problems, we are seeing meaningful improvements in outcomes while strengthening the culture of safety across our organization.”
