Psychological safety: How a healthy workplace can improve patient care

Medical Council representatives recently attended the Medical Board of Australia’s (MBA) National Conference, to learn about the initiatives helping build a positive culture in medical practice. Prioritising psychological safety in health settings has important implications across health services, and leaders in medicine are taking note of this. For practitioners, this means understanding key concepts can help prevent complaints and improve patient care.

What is psychological safety?

Psychological safety is the shared belief that team members can freely express themselves without fear of negative consequences. In medical workplaces, it allows for interpersonal risk-taking such as raising concerns, openly sharing ideas, and querying set practices. Building and maintaining psychological safety within teams leads to improved communication, increased engagement, and better patient outcomes. It builds a positive team culture, enhances collaboration, and encourages innovation and continuous improvement.

The importance of leadership
Healthcare leaders, including service and operational managers, team leaders, and clinical supervisors, hold a critical role in fostering psychological safety. By role-modelling, leaders can create an environment where team members feel safe to express their concerns, ask questions, and share ideas.

Practical tips
The Clinical Excellence Commission recommends leaders can build and maintain psychological safety with the following key actions:

  1. Active engagement: Demonstrate active listening, maintain eye contact, and ask questions to understand team members' concerns and ideas. Show that you are present and engaged in the discussions.
  2. Understanding and empathy: Use non-verbal cues to show understanding, such as nodding and leaning in. Reflect and paraphrase what you've heard to ensure accurate understanding.
  3. Learning culture: Avoid blame when something goes wrong and reframe it as a learning opportunity for the entire team. Encourage self-reflection and share your own reflections to promote self-awareness.
  4. Positive language and collaboration: Avoid negative language when speaking about others and discourage team members from engaging in negative talk. Create opportunities for collaborative decision-making, incorporating perspectives from the multidisciplinary team, patients, families, and carers.
  5. Authentic feedback and support: Be open to feedback from your team and create authentic channels for them to provide input. Champion your team's well-being and personal and professional development. Recognize and share the team's accomplishments with senior leadership.

In a multidisciplinary healthcare setting, psychological safety enables open discussions about patient care, safety, and quality improvement. Studies show a consistent association between workplace culture and patient outcomes in a variety of health settings. Promoting psychological safety can be done through role-modelling, actively engaging with healthcare teams, and fostering an environment of trust and open communication. Beyond protecting practitioner wellbeing, this approach can improve team efficiency, consistently deliver positive healthcare experiences, and ultimately improve patient outcomes.

Further information:
Psychological safety for managers and team leaders
Improve Quality - Safety fundamentals for teams

Studies show a consistent association between workplace culture and patient outcomes in a variety of health settings.