From Employee Well-being to Improved Outcomes: The Importance of Psychological Safety in the Workplace

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How is Your Individual Level of Psychological Safety in Your Workplace, Healthcare or Otherwise?

Your feeling of Psychological Safety is not “yes/no” – it's not a matter of feeling safe or not. There are degrees of safety, it's a spectrum.

Instead of asking, “do you feel safe to speak up about problems?” it's more like, “how safe do you feel?”

Timothy R. Clark defines Psychological Safety as:

“a culture of rewarded vulnerability.”

“Vulnerability” means:

“risk of loss or harm.”

“Culture” is the sum of our human interactions.

Nearly every human interaction is a vulnerable act (including introducing yourself to someone). But some acts are more vulnerable than others — they are more risky or greater loss could occur.

In healthcare, the most vulnerable acts might include:

* Saying I don't know how to do something (asking for help)

* Admitting a mistake

* Pointing out the risk of problems or mistakes

* Suggesting a better way of doing things

* Disagreeing with your manager (or an executive)

What's the level of psychological safety for you in your workplace?

Sadly, it's usually pretty low in healthcare organizations. That causes so many problems.

Punishment is Counterproductive

How often do people in leadership positions, unfortunately, PUNISH vulnerable acts? Do they realize how harmful that is to the culture and how it increases the risk of physical harm to patients and providers?

We build higher levels of Psychological Safety by REWARDING vulnerable acts.

It might seem helpful (or necessary) to punish mistakes, but that just drives mistakes further underground. People protect themselves by getting better at HIDING mistakes.

Thanking people for admitting a mistake — so we can work together to learn and improve — is not permitting people to be reckless. We have to thank people and be constructive, otherwise the mistakes are doomed to happen again.

I hope you work in a healthcare organization that has a relatively high level of Psychological Safety and that you feel it. I'd love to hear what you think. LinkedIn (where I posted a version of this) is not an anonymous forum, but my blog post here allows anonymous comments. Any real email addresses won't be shared. You can also just enter a fake email address if you need to.


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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.

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