WHAT IS IT? Psychological safety is a contemporary concept which refers to an individual's perception of the consequences of taking an interpersonal risk. Individuals feel comfortable being themselves, expressing concerns, and offering ideas without fear of ridicule. Explored by Harvard Business School in the 1990s, it was rooted in the observation that successful teams made more mistakes than less successful ones, but were more open and could learn from those errors. WHY DON’T WE HAVE IT? A traditional surgical hierarchical structure, combined with the high-stress nature of unwell patients has contributed to an uptake lag within our health industry. At an organisational level, barriers include inadequate training, absence of reporting systems or resource constraints. Team barriers include unfamiliarity/poor team cohesion, lack of communication, or hierarchy. On an individual level, high workload, knowledge deficit, fear of repercussion, cultural/gender differences and ego are the common factors. HOW DO WE IMPROVE? A multi-pronged approach provides the best chance of success. Government and hospital administration are crucial in shifting the existing landscape; assessment of the unique challenges faced by various stakeholders is required, followed by development of actionable steps. Next, providing an atmosphere of open communication, where all team members – regardless of hierarchy – feel empowered to speak up without ridicule. Finally, regular training and simulation sessions display the importance of psychological safety within clinical scenarios, its impact on patient outcomes, and practical strategies to enhance. Patient outcomes are improved not just by brilliant surgical technique but also by intangible systemic constructs that need upgrading.