The quality and culture of the health care work environment is known to affect care delivery. This commentary discusses human-centered and participatory design approaches as avenues for developing improvements in clinician well-being that will enhance safety for staff, providers, and patients.

Workers who experience psychological safety in their organization are more likely to speak up about safety concerns. This study reports on how trust and psychological safety interact to increase error reporting. Results indicate that trust in leaders encouraged error reporting and psychological safety encouraged learning from mistakes.

A culture of safety is foundational to successful patient safety initiatives. This systematic review explored the relationship between safety climate and safety-related behaviors across various industries, including healthcare.

Speaking up behaviors among healthcare workers is indicative of psychological safety and a culture of safety. This survey of healthcare staff working at seven sites across one hospital network in Australia found that speaking up behaviors are influenced by whether staff feel empowered in their roles and supported by their peers and supervisors.

The goal for health care organizations to attain high reliability is established but elusive. This article shares insights drawn from a Veterans’ Health system effort to support high reliability. The approach used centered on five components focusing on leadership, data systems, implementation, training, and safety culture.

Healthcare workers are at high risk of violence from patients, caregivers, and other healthcare workers. Researchers used three systems thinking methods (ActorMap, AcciMap, and PreventiMap) and stakeholder input to identify factors contributing to work-related violence incidents and interventions that can prevent or mitigate work-related violence.

Nurses’ willingness to speak up about resident safety concerns varies based on anticipated leadership response and support. Clinical and non-clinical staff at six Department of Veterans Affairs (VA) nursing homes with diverse safety climate ratings (high, medium, low) were interviewed to understand the association between resident safety and safety climate. Staff at high safety climate facilities described open communication and leadership responsiveness as contributors to a strong safety climate and willingness to speak up.

Health technology has improved many aspects of care, but can also introduce new safety concerns that require active monitoring and improvement. This commentary describes how learning health systems can improve the safety of new technologies, such as hiring health informaticists and collaborations with health authorities and vendors.

The redeployment of clinicians at the beginning of the COVID-19 public health emergency necessitated rapid training of staff, particularly those assigned to the intensive care unit (ICU). This review identified effective in-situ simulations that could be used in ICUs to restore and sustain patient safety following the COVID-19 pandemic. The in-situ simulations were able to detect latent safety threats and improve patient safety culture, interprofessional communication, and system organization.