Measuring psychological safety and local learning to enable high reliability organisational change

Abstract

The ability to measure the extent to which an organisation is highly reliable, or the extent to which reliability may change over time, has not kept up with the development of theory. The paper examines aspects of workplace culture, employee motivation and leadership behaviours that support continuous learning and improvement in an effort to measure the transition to high reliability.To evaluate the effectiveness of its high reliability initiative, one children’s hospital sought to build measures that would provide an assessment of progressive movement towards a ‘culture of safety’, and track the success over time. This paper reports on the development of two scales (trust in team members and trust in leadership) that are intended to measure two cultural conditions fostered by the five high reliability principles and a composite measure on local learning activities. The two scales are strongly associated with local learning activities in employees’ work areas and with employees’ willingness to participate in extra role activities. We suggest that they are foundational to creating a psychologically safe environment and thus to becoming a high reliability organisation.

Fostering Psychological Safety and Supporting Mental Health Among Cardiovascular Health Care Workers: A Science Advisory From the American Heart Association

“…Trust (in both leaders and team members/colleagues) plays a foundational role in the creation of psychological safety in the workplace. 22 It is critical to highlight that establishing psychological safety in health care work environments requires concerted efforts on multiple levels, encompassing individuals, teams/units, team/unit leaders, and health system administrators. These principles are relevant for people of all role types within health care settings.…”

“…e. Ensuring that debriefings occur after adverse/ negative events because this promotes effective learning conversations and ensures that mistakes are seen as learning opportunities. 22 The use of both explicit debriefing strategies-clear expectations, confidentiality, and commitment to respect-and implicit debriefing strategiespositive regard and behavioral integrity-is important to ensure a positive environment for participants. 27 f. Providing psychological support/resources for health care staff after adverse events occur (second victim support, assessment for depression or other mental health conditions).…”