During a recent HOP Fundamentals course, one participant shared a deeply personal experience that highlighted the relevance of Human and Organisational Performance (HOP) in healthcare. She recounted a visit she had taken to the hospital with her young child, during which a nurse’s error led to serious complications. Both the immediate and follow-up response from the unit was to place blame solely on the individual nurse, with little attention given to understanding how the incident occurred or how similar events could be prevented in the future in the days, weeks or even months after the event.
Reflecting on this experience through the lens of HOP principles, she realised that, even without detailed knowledge of the medical unit herself (coming from the mining industry), she could already identify environmental and systemic factors that contributed to the outcome. She described it as “a clear example of simple and obvious learning opportunities being missed because everyone became obsessed with who was to blame.”
This story showcases why HOP is increasingly being recognised as a powerful approach within the medical field, just as it has been in industries like aviation, energy, and construction. In these high-risk environments, HOP has shifted the focus within organisations from individual failure, to seeking to better understand how systems, context, and everyday pressures influence workers in the field—acknowledging that people are fallible and that errors are often symptoms of deeper issues.
The healthcare industry operates on the edge of failure every day, not because its people are careless, but because the systems they work in are complex, adaptive, and often brittle. Practitioners are constantly ensuring things go right in environments where success is anything but certain.
Expanding on Dr. Tedros’s insight above, the disconnect between how we imagine work to be done and how it actually unfolds is evident every single day in healthcare. For example, clinical procedures may be outlined in detailed protocols, but in practice, staff often need to adapt these steps in real time, navigating understaffing, equipment availability, or a patient’s unique needs- this is what makes work successful, most of the time. It’s not uncommon to hear a nurse say something along the lines of, “I know this isn’t exactly how it’s meant to be done, but…”. This is a constant reminder of their commitment to doing what’s needed in the moment to provide the best possible care. These adaptations are rarely documented or spoken about, yet they are essential for care to continue safely and effectively.
The healthcare industry is a vast, high-risk and complex place of work. We know that complex systems are highly hazardous with the possibility of failure around every corner. Despite this frontline practitioners consistently achieve successful outcomes by skillfully adapting to the demands of their work.
Human and Organisational Performance (HOP) is an approach which seeks to challenge more traditional safety approaches and programs, which focus heavily on compliance and punishment after workplace errors. These approaches often fail to improve safety in the long-term. Instead, HOP looks to better understand how and why people make mistakes, enabling us to design workplaces that anticipate and mitigate error, rather than simply blaming individuals one single event at a time.
HOP is based on five core principles that shape and influence the way organisations think, act, view success, and respond to failure.
Read more about the 5 principles of HOP →
When HOP principles are embedded into healthcare, a cultural shift will begin to take place. Staff will feel psychologically safe to speak up, empowering them to report concerns and share near-misses without fear of blame. In turn, leaders will respond with curiosity and support rather than punishment or focus on what went wrong and why.
Consider a common scenario that could occur at any hospital or health facility, at any given time: a clinician administers medication to a patient later than scheduled.
Traditionally, this might trigger a disciplinary response focused on individual accountability. However, a HOP-informed approach takes a different view—it seeks to understand why the delay occurred, recognising that the clinician did not intentionally set out to cause harm.
Instead we ask:
By exploring the broader context, we uncover systemic factors that contributed to the delay, leading to more meaningful and realistic improvements that will reduce real future risk, rather than solely assigning blame.
Applying this mindset in healthcare not only enhances safety and performance but also supports a culture of learning, trust, and continuous improvement where the goal is not to punish mistakes, but to understand and learn from them.
Over the past few months, the team at HOPLAB has noticed a significant increase in interest in HOP in the medical world. More and more healthcare professionals have been reaching out, curious about how the HOP approach could make a difference in their line of work. It’s been exciting to see this growing momentum especially given that the core HOP principles are a natural fit for the dynamic, high-stake world of healthcare.
If you or your team feel ready to embrace HOP, the first step is to start to build awareness and understanding of the core principles. Start small, gradually introducing and exposing HOP to a single unit or department, and over time, engage more influential leaders while expanding the reach to additional teams. This approach empowers you to begin shifting mindsets, strengthening knowledge, ultimately improving your operations safety and performance.
Ready to get started? Download our HOP in Healthcare Guide, or search upcoming HOP courses and online training.