Reliability has to do with “repeatability” or the capability of a process to perform consistently—the right way at the right time under the right conditions. Healthcare professionals hope to design reliable systems of care in order to prevent failure. Reliability in health care is often discussed in terms of the percentage of time that a system performs as it is designed to perform. Performance at less than 80% is considered chaos, according to the Institute for Healthcare Improvement. High reliability organizations(HROs) refer to organizations or systems that operate under hazardous conditions, but have learned to mitigate the high‐risk, error‐prone nature of the organization’s activities; they do so by studying failure, developing the ability to contain unanticipated events, and by attentive listening to front-line workers for help in identifying threats to reliability (this open dialogue is often referred to as “a culture of safety”). In a culture of safety, you will see all levels of staff involved in root cause analyses, debriefings of error events, and modeling of procedures and processes.