Safety in high-reliability organizations: The role of upward voice, team learning, and safety climate (16 February 2025)

Summary

High-reliability organisations (HROs), such as nuclear power plants, petrochemical plants, or aviation are complex systems in which safety is a critical component when it comes to achieving success and preventing catastrophic accidents. The WHO Global Patient Safety Action Plan identifies building high-reliability health systems and health organisations as a key objective in seeking to protect patients from avoidable harm.

In HROs, upward voice (the willingness and ability of lower-status or frontline personnel to speak up about concerns, errors, near misses, or potential safety threats to those in higher authority) contributes to a proactive approach to safety and allows the early identification of potential problems before they cascade into tragic consequences. This study responds examines the relationship between upward voice and safety performance, and the mediating role of team learning in this relationship, looking at a sample composed of 617 workers from two nuclear power plants of the same organisation.