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Psychological Safety in Healthcare: Creating a Culture of Safety and Excellence

Updated: Jun 26

In the fast-paced and high-stakes world of healthcare, where lives are on the line and every decision matters, fostering a culture that encourages transparent communication, trust, and innovation is not just a nice-to-have—it's an absolute must for any healthcare organization that wants to deliver the best possible patient outcomes. At the heart of this trusting and innovative culture lies a critical element called psychological safety. Many healthcare organizations, like the Mayo Clinic and Cleveland Clinic, have come to understand that it's the cultural element that can highly influence the level of success an organization experiences.


What is Psychological Safety in Healthcare

Psychological safety in healthcare refers to an environment where healthcare professionals feel comfortable expressing their ideas, opinions, and concerns without fear of negative consequences. It is a shared belief that the team is safe for interpersonal risk-taking, allowing individuals to be vulnerable, make mistakes, and learn from them without being punished or humiliated.


Definition of Psychological Safety

Psychological safety is defined as "a shared belief held by members of a team that the team is safe for interpersonal risk-taking" (Amy Edmondson, 1999). In other words, it is the assurance that an individual will not be rejected or punished for speaking up with ideas, questions, concerns, or mistakes. A study by Google found that teams with higher levels of psychological safety had a lower rate of medical errors.


Why is Psychological Safety Important in Healthcare

Psychological safety is essential in healthcare for several reasons:

  1. Encourages open communication and idea-sharing, leading to better patient care. A study by the University of Michigan found that hospitals with higher levels of psychological safety had better patient outcomes and higher patient satisfaction scores.

  2. Promotes learning and innovation, which is crucial in the ever-evolving field of medicine and it helps to develop the cutting edge care that helps patients

  3. Enhances team performance and productivity, resulting in improved patient outcomes as well as higher rates of engagement among employees

  4. Reduces healthcare professional turnover and burnout, which is a significant issue in the industry (according to a 2019 National Nurses United survey, 44% of nurses reported feeling burned out). Creating psychologically safe work environments creates a better work environment and helps employees to feel that they are valued and that their voices are heard.

  5. Fosters a positive and inclusive work culture, which is essential for the organizational brand and reputation and which helps in attracting and retaining top talent


What Psychological Safety is Not

It is important to note that psychological safety does not mean the absence of conflict or a lack of accountability. It does not imply that all ideas will be accepted without constructive criticism, or that poor performance will be tolerated. Instead, it creates an environment where challenges and disagreements can be addressed respectfully and constructively.


The Difference Between Psychological Safety and Accountability

Psychological safety and accountability are often seen as opposing forces, but they can and should coexist. Psychological safety enables healthcare professionals to take risks and be vulnerable, while accountability ensures that individuals take responsibility for their actions and outcomes. A balanced approach that combines both elements is essential for creating a high-performing and psychologically safe healthcare team.


Healthcare Leaders' Role in Creating a Psychologically Safe Culture

Healthcare leaders play a crucial role in fostering psychological safety within their teams. Some key responsibilities include:


  • Leading by example and being open to feedback

  • Encouraging open communication and active listening

  • Providing support and resources for learning and growth

  • Addressing conflicts and issues in a constructive manner

  • Recognizing and rewarding vulnerability and risk-taking


Healthcare Professionals' Role in Creating a Psychologically Safe Culture

While leaders set the tone, healthcare professionals also have a responsibility in creating a psychologically safe environment. They can contribute by:

  • Being open and honest in their communication

  • Actively listening to and respecting others' perspectives

  • Supporting and encouraging their colleagues

  • Taking ownership of their mistakes and learning from them

  • Providing constructive feedback and engaging in healthy debates


Real-Life Examples of Psychological Safety in Healthcare

  • A team member admits to a medication error during a team huddle, and the team collaboratively works on identifying the root cause and implementing a solution to prevent future occurrences.

  • A physician proposes a novel treatment approach during a case review, and the team encourages further exploration and research into the potential benefits and risks.

  • A healthcare leader acknowledges their own knowledge gaps and seeks input from frontline staff to make informed decisions about patient care protocols.


Practical Ways to Work on Creating a More Psychologically Safe Healthcare Team

  • Conduct regular check-ins and debriefing sessions to discuss successes, challenges, and lessons learned

  • Encourage open-ended questions and active listening during team meetings and patient handoffs

  • Celebrate near-misses and adverse events as learning opportunities, rather than assigning blame (a study by Brigham and Women's Hospital found that implementing a non-punitive reporting system increased the number of reported errors by 40%)

  • Implement a "just culture" policy that balances accountability with fairness and focuses on system improvements

  • Provide training on effective communication, teamwork, and conflict resolution skills

  • Foster a culture of inclusivity and respect for diverse perspectives, recognizing that diversity leads to better problem-solving and decision-making


Creating a psychologically safe healthcare workplace is a continuous process that requires commitment and effort from both leaders and healthcare professionals. By understanding the importance of psychological safety, recognizing its benefits, and implementing practical strategies, healthcare organizations can build a culture that promotes trust, innovation, and high-quality patient care. Remember, psychological safety is not about avoiding challenges or accountability, but rather creating an environment where healthcare professionals can thrive and contribute their best work for the benefit of their patients.

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