This presentation discusses what a high reliability organization is and why organizations increasingly need to move in the direction of enhanced reliability and mitigation of risk. It then mentions the three organizations initially studies as high reliability organizations and suggests that where we can we should disaggregate parts of our organizations. It then identifies a number of organizations that have tried to become high reliability organizations and further delves into the experiences of one of those organizations in reaching enhanced reliability. It wraps up by saying it is possible to develop a reliability enhancing culture but such cultures are extremely fragile and need to be worked at constantly if they are to survive.