Introduction: This study investigates High Reliability Organizations (HROs) in the Gulf Country Region, focusing on the Healthcare sectors. HROs are known for their ability to minimize accidents despite operating in hazardous environments. Given the rapid demand growth of the healthcare in the region, the adoption of HRO principles is crucial to ensure operational safety and reliability. Methods: A cross-sectional study design was employed to examine the knowledge and the implementation of HRO principles across various organizations in the two Gulf countries (i.e., Kingdom of Saudi Arabia and United Arab Emirates). Data were collected through surveys among 533 healthcare staff with key stakeholders, including leadership and operational staff. The study focused on assessing safety culture, leadership support, and familiarity with HRO principles. Results: The findings reveal varying levels of HRO familiarity and application across the region. Organizations in the United Arab Emirates exhibited stronger adherence to HRO practices compared to others. However, gaps were identified in continuous training and leadership commitment. Respondents highlighted the importance of promoting a proactive safety culture and enhancing organizational resilience to handle unexpected risks effectively. Conclusion: The study highlights the gaps in knowledge and underscores the significance of adopting HRO principles to improve safety outcomes in high-risk industries. It recommends targeted training, leadership development, and policy interventions to strengthen safety culture and high reliability principles. The research offers valuable insights for policymakers and industry leaders in the Gulf Country Region to promote high reliability in their operations.
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