Psychological Safety Exists on a Spectrum
How is Your Individual Level of Psychological Safety in your workplace, healthcare, or otherwise?
Psychological safety is not a yes-or-no condition–it exists in degrees. 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?”
What Psychological Safety Really Means
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.
The Most Vulnerable Acts at Work–Especially in Healthcare
- 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–and Increases Risk
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.
Psychological Safety Is Built Through Repeated Leadership Actions
Psychological safety does not come from policies, training sessions, or slogans about being “open.” It emerges from repeated experiences that teach people what is truly safe to do at work.
When leaders punish vulnerable acts–admitting mistakes, asking for help, or pointing out risks–people quickly learn to protect themselves by staying silent. Problems go underground, learning slows, and harm becomes more likely.
When leaders reward those same vulnerable acts–by listening, thanking people, and responding with curiosity–psychological safety grows. Not because leaders say it should, but because people experience it.
Over time, those daily responses shape behavior, culture, and outcomes. Psychological safety is not something leaders announce. It is something people feel–based on what happens after they speak up.
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 email addresses won't be shared. You can also just enter a fake email address if you need to.
Please scroll down (or click) to post a comment. Connect with me on LinkedIn.
If you’re working to build a culture where people feel safe to speak up, solve problems, and improve every day, I’d be glad to help. Let’s talk about how to strengthen Psychological Safety and Continuous Improvement in your organization.
