Introduction: Patient safety and high reliability related to obstetric care has become a global concern especially during this COVID-19 pandemic period.Aim of this study is to assess the components of Socio Technical system as the factors affecting while adopting High-Reliability Organization (HRO) Principles as perceived by staff. Methodology: This is a hospital based descriptive cross-sectional study conducted using a self-administered questionnaire.Results: Out of the five factors affecting HRO practices as perceived by staff, "Organizational Safety Culture" (Mean- 4.25., SD-0.454 Significant at <0.01 level), Communication (SD-4.15, SD-0.579), and Teamwork (Mean:3.95, SD:0.499). are having a statistically significant (p <0.05 corresponding to Spearman’s correlation Coefficient positive association with the practice of HRO principles. According to Multiple linear regression model explains 29% of the variability of the HRO practices (dependent variable) can be explained by the factors affecting HRO practices (independent variables) if all the factors operate together. Gender, age, educational level, designation and working experience act as moderating variables to Organizational Safety Culture. There is a significant (p <0.05) difference of HRO practices among female gender, nursing category of staff which is better than other categories.Conclusion: Organizational safety culture, communication and Teamwork and work environment show significant effect on determining HRO practices which is important for policy makers and administrators to pay attention on above three factors to improve reliability. But these five factors (including leadership and working environment) explains only one third of variability of HRO practices), hence need to study other factors affecting reliability of performance.

There is a growing concern regarding patient safety and high reliability which made more intense with this ongoing pandemic.Aim of this study is to assess the organizational factors affecting the practice of High-Reliability Organization (HRO) Principles as perceived by staff in selected Accident and Emergency Units. Methodology: A hospital based cross-sectional study in three Accident and Emergency care setting, among healthcare staff, conducted using a self-administered questionnaire.Results: Out of the five factors affecting HRO practices as perceived by staff, “Organizational Safety Culture” (Mean-4.27., SD-0.49) has the highest mean value followed by Leadership (Mean: 3.96, SD: 0.44) and Teamwork (Mean: 3.95, SD: 0.5). “Work Environment” (Mean: 3.94, SD: 0.46) has the lowest score. All independent and dependent variables have a significant positive correlation with HRO principles (Correlation is significant at the 0.01 level-1-tailed). Multivariate analysis was carried out to assess the proportion variability of the dependent variable. The linear regression model explains 22% of the variability of the HRO practices (dependent variable) by factors affecting HRO practices (independent variables) if all the factors operate together.The distribution of Coefficients, Standardized B value is 0.29 (significant at the 0.01 level), showing if “Organizational Safety Culture” operates together with the other four independent variables 29% of the variability of the HRO practices (dependent variable) can be explained by Organizational Safety Culture.Conclusion: Organizational safety culture shows significant (< 0.01) effect on determining HRO practices.