This article explores aspects of health-care systems that make shared or organisational learning from failure difficult, and recommends strategies for overcoming these barriers, emphasising the critical role of leadership. Leaders must create a compelling vision that motivates and communicates urgency for change; work to create an environment of psychological safety that fosters open reporting, active questioning, and frequent sharing of insights and concerns; and empower and support team learning throughout their organisations as a way of identifying, analysing, and removing hazards that threaten patient safety.