Wellness comprises psychological and physical elements. Psychological safety is a crucial and often underexplored area in healthcare. This includes the staff’s feelings of safety among one another.
A lack of inclusion or connection among healthcare staff can create significant risk. It stops people from being authentic and bringing their best to work because, deep down, they aren’t sure if their best will earn them approval or rejection.
Let’s discuss psychological safety in healthcare, what it is, and why it’s so important.
What is psychological safety?
Psychological safety is the ability to express one’s beliefs freely without fearing potential negative consequences. When you feel psychologically safe, you are comfortable speaking up and sharing your true thoughts without being judged, ostracized, or negatively impacting your reputation.
Psychological safety is fundamental to creating a safe, transparent work environment. If there’s one industry where open communication is vital, it’s healthcare.
In healthcare, however, psychological safety may be absent among close-knit nursing staff that accept an invisible hierarchy. New nurses, or those with less experience, may feel compelled to adhere to whatever the higher-ranking nurses believe, regardless of the soundness of said beliefs.
How does psychological safety factor into healthcare?
To err is human. All doctors and nurses are humans. They will make mistakes. They need coworkers they can trust to point out any potential errors that could harm their patients. In medical practices, psychological safety is the difference between feeling comfortable enough to speak up and question a recommendation and staying silent out of fear of the potential negative consequences resulting in a care plan that ultimately harms a patient.
Imagine that a nurse asks for clarification on a patient’s dose. The amount written on the doctor’s prescription seems too high, but the nurse is too afraid to question this. Instead of clarifying, they give the patient what’s written on the care plan potentially causing more harm to the patient’s health and well-being.
In this case, the nurse would be at fault for not ensuring that the appropriate dose was administered. While the nurse is solely responsible for his/her actions, another factor should be considered — the psychological safety of the nurse’s environment.
Why didn’t the nurse feel comfortable questioning the physician when they felt the medication dosage was wrong? What did the nurse fear, and why was that fear stronger than the responsibility/desire to protect his/her patient?
In healthcare, psychological safety is key to patient safety. Healthcare workers afraid to share their honest thoughts ultimately put their patients at risk. It is vital that every staff member, regardless of title or rank, is regularly reassured that their voice matters and that they can trust their colleagues to listen. So, practicing psychological safety in healthcare is critical to ensure that the best patient care is administered every time.
Importance of Psychological Safety in Healthcare
Healthcare organizations can improve the safety of the care they provide in two ways.
They can retrospectively study an adverse event through the Root Cause Analysis (RCA) process. They can prospectively look at areas of latent risk through the study of Close Calls or Near Misses. Recognizing a near miss requires speaking up and pointing to a latent risk that almost led to an adverse event. This can only occur if the person with the knowledge of the risk feels safe speaking up.
Too often, unfortunately, workers likely did notice the potential for harm, but they didn’t feel comfortable addressing it or lacked access to the channels required to report it.
Part of psychological safety requires respectful, open communication. Dr. Amy Edmondson, the author of The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth, expresses the importance of people being able to voice thoughts even when they aren’t fully supported by fact. The goal is to create opportunities to have these conversations, explore the potential risks, and come up with solutions to problems before they lead to catastrophic results.
Ways to Improve Psychological Safety in Healthcare
Dr. Timothy Clark, CEO of LeaderFactor, in his book, The 4 Stages of Psychological Safety: Defining the Path to Inclusion and Innovation, outlines the four steps:
- Inclusion Safety. The foundational stage focuses on making sure everyone feels connected and part of a group. The staff should feel that they belong and feel accepted and embraced for all their unique qualities.
- Learner Safety. Everyone should feel comfortable asking questions and providing and receiving constructive feedback.
- Contributor Safety. People are comfortable applying their skills and knowledge in new ways to make meaningful differences in the workplace.
- Challenger Safety. The highest and most difficult level of psychological safety requires staff to feel comfortable voicing their opinions even when it goes against the majority consensus.
To increase communication and improve psychological safety, you must work systematically. Workers need to feel safe and included before they can openly share differing opinions.
When anxiety or fear of rejection is replaced by trust, people will be less afraid of owning their mistakes because they’ll see them as opportunities to improve the safety of the care they provide.
Proven ways to improve psychological safety include:
- Holding team-building exercises
- Explicitly training and prioritizing psychological safety
- Establishing clear communication practices
- Creating procedures for people to follow when they need to voice concerns
- Embracing and training staff members to engage in constructive, respectful conflict
Disagreement is not to be avoided or squashed. Disagreement can lead to breakthroughs that ultimately help everyone perform their jobs better. What matters most is how organizations and individual teams interpret and validate disagreements. Is someone’s different opinion a slight to the established social order? Do people risk losing approval and support if they don’t agree with the crowd or a supervisor’s opinion?
While hierarchies are important in most circumstances, they should not be obliged at the expense of safety. Positive alternatives can’t arise from an echo chamber; everyone matters, and everyone’s voice counts.
How Coaching Can Improve Psychological Safety
Coaching can help your team learn how to create psychological safety in the workplace. It can also help leaders understand and utilize proven strategies to overcome barriers to psychological safety and effective communication.
To learn more about psychological safety and how it can be effectively implemented in various industries, reach out to me today. Ensure everyone in your reach feels they can speak up because their thoughts, actions, behaviors, and beliefs matter.