HIGH RELIABILITY HEALTHCARE: FUNDAMENTALS OF QUALITY AND PATIENT SAFETY

Every year, preventable harm kills and disables patients in health systems that are otherwise well-resourced, well-intentioned, and technically capable. The problem is rarely a shortage of good people. The problem is a shortage of the right systems — systems designed from the ground up to be reliably safe, consistently excellent, and relentlessly learning.

This book is the authoritative guide to building those systems.

Drawing on decades of clinical experience, global research, and the principles of High Reliability Organisation theory, Professor Rubin Pillay delivers a comprehensive, practical, and deeply readable text for everyone who works in, leads, or is responsible for healthcare quality. From the foundational concepts of quality management and performance measurement, through the operational mechanics of patient safety improvement, risk management, and root cause analysis, to the governance structures that sustain excellence across time — every chapter equips the reader with the knowledge and the tools to make healthcare measurably safer.

What distinguishes this book is its dual architecture. The international evidence base and global best practice are rigorously presented and made practically actionable. And then — uniquely for a text at this level — the content is contextualised for the South African health system by Winnie Moleko and Grace Labadarios, integrating the National Health Act, OHSC Norms and Standards Regulations, the Early Warning System, and the realities of both the public and private healthcare sectors. The result is a book that is simultaneously world-class in its intellectual ambition and immediately usable in a South African ward, clinic, or boardroom.

The eleven chapters cover the full landscape of healthcare quality management: introducing quality frameworks and high reliability theory; exploring the five foundational elements of High Reliability Organisations through vivid real-world cases including the Tenerife air disaster; building rigorous systems for performance measurement, data collection, and evaluation; leading quality improvement projects using PDSA, Rapid Cycle Improvement, and Lean methodologies; managing patient safety incidents, adverse events, and risk; ensuring individual clinical competence through credentialing and privilege delineation; managing healthcare resources, utilisation, and outcomes; and, finally, understanding the patient experience as both a moral imperative and a measurable quality domain.

Foreword by Dr Sibongiseni Dhlomo, MD, Member of Parliament and Deputy Minister of Health, South Africa.

This book is essential reading for:

• Healthcare managers, quality officers, and patient safety leads
• Clinical professionals seeking a structured foundation in quality science
• Health administrators and hospital board members
• Nursing and medical educators and their students
• Health policy professionals and regulatory authority staff
• Anyone preparing for quality and patient safety accreditation or certification