Healthcare organizations across the United States have begun the journey to high reliability as one method for improving patient safety. Being a High Reliability Organization (HRO) requires constant vigilance for ensuring the delivery of system-wide excellence in patient quality and safety. Establishing a foundation for high reliability requires the engagement of personnel across the organization from frontline staff to executive leadership. Staff must feel comfortable voicing concerns in order to be fully engaged. However, we believe this is easier said than done. The purpose of this article is to describe the importance of psychological safety along the journey to becoming an HRO. Additionally, strategies for promoting a psychologically safe work environment are provided.
