Collaborative High Reliability® for Physicians – Public Edition

An SGCS Orientation Series Course

In this free 25-minute course, Collaborative High Reliability® expert Paul LeSage introduces the Sequence of Reliability™ and describes how it is used to see and understand the many risks surrounding healthcare providers each day. While this course examines an error made by a physician, it is relevant for anyone providing direct care. Clinicians, physician assistants, pharmacists, nurse practitioners and others in similar front-line healthcare delivery roles will identify with the case presented.

Operationally reliable organizations are comprised of reliable individuals. This short course will prepare team members to become more performant, and provide them with some tools for managing risks in every aspect of their life and work.

For information on how to obtain SGCS Collaborative Just Culture® and Collaborative High Reliability® training and qualification for your organization, contact SGCS at

Module 1: Introduction

Collaborative High Reliability expert Paul LeSage introduces physicians to the concept of High Reliability and discusses the key terms used to describe it.

Module 2: The Sequence of Reliability™

Seeing and understanding risk that is present but not always visible is a key component in Collaborative High Reliability. This module introduces a taxonomy for this, and shows viewers where to look for it. The iceberg metaphor is used to illustrate how risks and events that are visible above the waterline are a small fraction of the many risks that actually exist. To become highly reliable, we must look below the waterline to identify and address risk before harm occurs.

Module 3: Risk Perception and Risk Tolerance

Risk tolerance and risk intelligence are related, and differ from person to person. Our experiences and perceptions impact our ability to recognize risk, and is a key reason why organizations struggle in the area of operational reliability and stability. We like to think we’re safety minded and doing the right things … but are we?

Module 4: How Priorities Influence Behavior

We have a tendency to punish behavior without first examining the systems that influence behavioral choices and actions. Policies and rules are poor barriers to behavior. By using the Sequence of Reliability to identify and manage risk, and to see the actual priorities that our policies and rules create, we can build barriers to undesirable behavior that actually work.

Module 5: Applying the Sequence of Reliability

The Sequence of Reliability is not just a method for managing risk at work — it applies to all walks of life. In this final module, Paul LeSage summarizes the steps in the sequence and provides an example from his personal experience.

Key Takeaway:

Continue to think about the iceberg. Remember that what is below the waterline is what should concern you the most.

All content on this site is © SG Collaborative Solutions LLC, all rights reserved. Please do not copy or distribute without express written permission.

Course Information
  • Course Id:Orientation Series
Paul LeSage