Serious events within healthcare occur daily exposing the failure of the system to safeguard patient and providers. The complex nature of healthcare contributes to myriad ambiguities affecting quality nursing care and patient outcomes. Leaders in healthcare organizations are looking outside the industry for ways to improve care because of the slow rates of improvement in patient safety and insufficient application of evidenced-based research in practice. Military and aviation industry strategies are recognized by clinicians in high-risk care settings such as the operating room, emergency departments, and intensive care units as having great potential to create safe and effective systems of care. Complexity science forms the basis for high reliability teams to recognize even the most minor variances in expected outcomes and take strong action to prevent serious error from occurring. Cultural and system barriers to achieving high reliability performance within healthcare and implications for team training are discussed.

LESLIE M. McKEON

JILL D. OSWAKS

PATRICIA D. CUNNINGHAM

Clinical Nurse Specialist

《临床护士专家™：国际高级护理实践杂志》的目的是传播临床护士专家实践的成果，促进临床护士专家角色的持续发展，并突出临床护士专家对推进护理实践和卫生政策的贡献全球范围内。该期刊的目标是： 1. 传播有关临床护士专科能力以及实践教育和规范的知识； 2. 就整个护理过程中护理和健康服务的质量、安全和成本交流临床护理专家实践的结果； 3. 推动护理卫生政策转型的循证实践和创新，造福社会； 4. 促进针对不同护理环境和文化中特殊人群的护理和健康服务的专业内和跨学科对话。

The purpose of the Clinical Nurse Specialist™: International Journal of Advanced Nursing Practice is to disseminate the outcomes of clinical nurse specialist practice, promote the ongoing development of the clinical nurse specialist role, and highlight the contributions of clinical nurse specialists to advancing nursing practice and health policy globally. The journal aims to: 1. Disseminate knowledge regarding clinical nurse specialist competencies, as well as practice education and standards; 2. Communicate the results of clinical nurse specialist practice concerning the quality, safety, and cost of nursing and health services throughout the nursing process; 3. Promote evidence-based practice and innovation in transforming nursing health policy for the benefit of society; 4. Facilitate intra- and interdisciplinary dialogue on nursing and health services for special populations in diverse nursing environments and cultures.

《Clinical Nurse Specialist™：国际高级护理实践杂志》旨在传播临床护士专家实践的成果，促进临床护士专家角色的持续发展，并突出临床护士专家在推动护理实践和卫生政策方面的全球贡献。该期刊的目标包括：1. 传播有关临床护士专科能力、实践教育和规范的知识；2. 交流临床护理专家实践在护理和健康服务质量、安全和成本方面的成果；3. 推动护理卫生政策转型的循证实践和创新，以造福社会；4. 促进针对不同护理环境和文化中特殊人群的护理和健康服务的专业内和跨学科对话。

Category	Quartile
医学	4
医学, 护理	4

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