TY - JOUR T1 - Measuring psychological safety and local learning to enable high reliability organisational change JF - BMJ Open Quality JO - BMJ Open Qual DO - 10.1136/bmjoq-2021-001757 VL - 11 IS - 4 SP - e001757 AU - Jenifer Cartland AU - Michaeleen Green AU - Desty Kamm AU - Diana Halfer AU - Mary Alida Brisk AU - Derek Wheeler Y1 - 2022/10/01 UR - http://bmjopenquality.bmj.com/content/11/4/e001757.abstract N2 - 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.Data are available upon reasonable request. ER -