Veterans Health Administration (VHA) is America’s largest integrated health care system, serving 9 million enrolled Veterans each year at over 1,300 health care facilities. VHA is committed to the Journey to High Reliability and its transformation to become a High Reliability Organization (HRO) across its central office and integrated health care system. The journey formally commenced in 2019 with a group of 18 lead facilities, followed by subsequent facility cohorts in 2020 and 2021. To support this transformation, VHA adapted existing HRO frameworks and tools to develop the High Reliability Assessment and Planning Model, which was used to conduct baseline HRO assessments at Veterans Affairs Medical Centers across the nation. The Model was not developed with the intent to grade or compare the HRO maturity levels of individual facilities, but rather as a tool to assess the progress of each facility, identify gaps, and create plans for next steps along the Journey to High Reliability. In addition, it is intended to align with other existing frameworks and maturity models, including IHI’s Framework for Safe, Reliable and Effective Care, The Joint Commission’s High Reliability Healthcare Model, and the National Action Plan to Advance Patient Safety. As it works to continuously improve its HRO assessment process, VHA identified opportunities to refine and optimize the baseline versions of the Model to ensure its usability across all VHA organizations. This improvement cycle included a review of literature and an exploration of best practices from private-sector organizations that have advanced in High Reliability. VHA leaders and subject matter experts conducted a gap analysis to develop recommendations for the next iteration of the Model. Once completed, the tool was piloted across various settings throughout VHA before broad implementation. This session will describe the development of the High Reliability Assessment and Planning Model and the improvement cycle applied to optimize it. Attendees will have the opportunity to review specific frameworks, tools, and lessons learned from early piloting and adoption of the updated Model to help support their own organizations’ Journeys to High Reliability.