Leveraging Medical Staff Structures to Advance High Reliability

As hospitals and health systems pursue high reliability, the role of the organized medical staff remains an underutilized but powerful lever for transformation. This session explores how traditional structures within medical staff governance—when realigned with purpose—can actively support the High Reliability Framework articulated by Allan Frankel and Michael Leonard, which includes three key domains: leadership commitment, safety culture and learning system.

Drawing on real-world experience and institutional case examples, this session will demonstrate how credentialing, privileging and structured peer review processes can reinforce leadership engagement in safety and quality. Objective performance evaluation systems (OPPE/FPPE) and integrated professionalism initiatives can foster a culture of psychological safety, transparency and learning—hallmarks of high-reliability organizations. Medical staff governance also provides critical infrastructure to meet emerging national patient safety structural measures, including the integration of just culture principles into event adjudication.

The session will also showcase how medical staff leadership development and succession planning—especially through nominating committees, department chair training and wellness programs—can embed shared accountability and alignment with organizational quality goals. Further, professionalism programs and peer review can be designed to address behaviors that undermine safety while promoting respectful, team-based care. Importantly, this discussion will include strategies for physician engagement in co-designing governance solutions and the role of equity in evaluating clinical performance and professional conduct.

Participants will leave with actionable approaches to transform legacy structures into dynamic systems that drive cultural change, process reliability and safer care delivery. This session is ideal for senior executives, physician leaders and quality leaders seeking to move beyond compliance and leverage the unique strengths of their medical staff to achieve sustained high performance and reliability across the care continuum.