ArticleHigh Reliability Organization Principles Improve VA Workplace Burnout The Truman THRIVE2 ModelIsaacks, David B. MA, FACHE1; Anderson, Tim M. RN, MS2; Moore, Scott C. PhD3; Patterson, William MD, MSS2; Govindan, Sushant MD, MSc4 Author Information 1Kansas City Veterans Affairs Medical Center, Kansas City, MO 2Veterans’ Health Administration, VA Heartland Network, Kansas City, MO 3Veterans’ Health Administration National Center for Organization Development, Cincinnati, OH 4Pulmonary and Critical Care Medicine Service Line, Kansas City Veterans Affairs Hospital, Kansas City, MO Corresponding Author: David B. Isaacks, MA, FACHE, 4801 Linwood Blvd, Kansas City, MO 64128. Email: [email protected] Online date: May 18, 2021 American Journal of Medical Quality: November/December 2021 - Volume 36 - Issue 6 - p 422-428 doi: 10.1097/01.JMQ.0000735516.35323.97 Buy Metrics Abstract Provider burnout is a significant health care concern. It is unclear whether high reliability organization (HRO) practices can prevent it. The Truman Veterans Affairs Medical Center (VAMC) undertook an initiative implementing HRO principles and assessed for impact on burnout metrics. This became known as the Transformative HRO Initiative Via Employee Engagement (THRIVE2) model. THRIVE2 consisted of Just Culture training, Clinical Team Training, and continuous process improvement through Lean. Truman VAMC was compared with other Veterans Health Affairs (VHA) facilities regarding burnout and employee satisfaction metrics. Truman VAMC saw significant changes in multiple HRO metrics (P < 0.001) as well as improvements in work group psychological safety and employee exhaustion (P < 0.001). High burnout rates decreased by 52% (6.2%–2.95%; P < 0.001). Truman VAMC went from 75th to the No. 1 ranked VHA facility regarding Best Places to Work. These findings have significant national policy implications given the effects of burnout. Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.