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Kathleen Sutcliffe

Organizational Theory & Patient Safety

Carey Business School
Armstrong Institute for Patient Safety & Department of Anesthesiology and Critical Care Medicine, School of Medicine
Department of Acute and Chronic Care, School of Nursing

Organization theorist Kathleen Sutcliffe studies high-reliability organizations and group decision making in order to understand how organizations and their members cope with uncertainty and unexpected events, with a focus on reliability, resilience, and safety in health care.

One stream of work focuses on top management teams and group dynamics, including information search processes, communication, and learning processes, and how these elements affect firm performance.  In a second stream of work, she investigates organizational reliability, particularly how an organization’s design and culture influence its members’ abilities to sense, cope with, and respond to unexpected and changing demands.

In the past ten years, she has investigated these issues in many organizational contexts, including in healthcare where she has examined the systemic/organizational origins of medical mistakes and factors that affect the capabilities to catch, correct, and cope with errors in high-risk, dynamic systems.  She has also studied safety organizing behaviors in high risk settings such as healthcare, wildland firefighting teams, and oil and gas exploration.

While serving as health director for Aleutian Pribilof Islands Association, one of the 13 Alaska Native regional corporations, she realized that she “was always thinking about organizations and not individuals. I thought, How can we make it better? I didn’t want to run the organization, but I wanted to understand what goes into making it great.”

Sutcliffe became fascinated with “high reliability organizations,” such as aviation or nuclear power companies, which regularly avoid catastrophes in complex, high-risk environments. These organizations, she says, have several behaviors in common: They build a context of trust and respect, help people understand the larger goals of the system, recognize the small factors that might lead to failure, and establish flexible decision-making structures, among others.

“I thought this idea could be brought to other industries, especially health care,” says Sutcliffe, who later earned her doctorate in organizational behavior and theory and previously spent 20 years at the University of Michigan, where she was the Gilbert and Ruth Whitaker Professor of Business Administration and a professor of management and organizations.

Sutcliffe’s first few papers on using “high reliability” approaches in health care, which she published with one of her doctoral students, showed that nursing units engaged in such behaviors made fewer medication errors and had fewer patient falls as well. She’s gone on to study safety culture and has created a model for it that, she says, is more practical and useful than previous models.

At Hopkins, she has joined the Individualized Health Initiative to help doctors improve treatment, testing, and prevention for their patients and will work with the School of Medicine’s Armstrong Institute for Patient Safety “to use what we’ve learned from organizational theory to help create excellent health care institutions.”

Sutcliffe has also worked and consulted on matters related to safety organizing and safety culture for a variety of entities, ranging from governmental agencies such as the Department of Homeland Security and the Fire Department of New York; to non-governmental organizations such as the Mayo Clinic; to private multinational companies around the world, including General Electric, Hewlett-Packard, and Target.

She is the author of Managing the Unexpected: Resilient Performance in an Age of Uncertainty with co-author Karl E. Weick, Medical Error: What Do We Know? What Do We Do? with Marilynn M. Rosenthal, and A Ready and Resilient Workforce for the Department of Homeland Security: Protecting America’s Front Line with the Committee on the Department of Homeland Security Workforce Resilience.

She holds a PhD in Management (organization theory and organizational behavior) from the University of Texas at Austin, a M.N. from the University of Washington, a B.S. from the University of Alaska, and a B.A. from the University of Michigan.  She is a member of the Academy of Management and the Strategic Management Society.

Bloomberg Distinguished Professors


Vice Provost for Research

265 Garland Hall
3400 North Charles Street
Baltimore, MD 21218

(410) 516-8094

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