By Esther Espunyes, EORNA President
Last week, I reflected on why perioperative nurses are essential to safe surgery. But safety cannot depend on individual commitment alone. It needs to be embedded in the way an organisation thinks, leads and works.
High Reliability Organisations offer an important perspective. They operate in complex environments where the consequences of failure can be significant, yet remain focused on anticipating risks, learning continuously and maintaining a constant awareness of what could go wrong.
So, what can we learn from this approach in our operating rooms?
A safe work environment is built through everyday actions: encouraging open communication, empowering professionals to speak up, learning from near misses and errors, and recognising that safety must remain a priority, even when the pressure is high. A safe working environment is built through everyday actions: encouraging open communication, empowering healthcare professionals to raise concerns, continuous formal education and through informal education, learning from near misses and errors, and recognising the fact that safety must remain a priority even when the pressure is high.
But creating this environment is also a leadership responsibility. Management must demonstrate, through decisions, priorities and resources, that safety is not simply a statement or a policy. What leaders prioritise, measure and support sends a powerful message about what truly matters.
And ultimately, organisational culture influences more than safety outcomes. It shapes how patients experience their care — whether they feel respected, informed, listened to and protected.
A culture of safety is a culture of care — built not on obligation, but on shared belief, commitment and responsibility.
As leaders and professionals, our challenge is to create environments where both can thrive.
Next week, I will reflect on why some of the most important moments for patient safety happen before the first incision. That is where our next conversation begins.
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