Performance Health Partners
Fostering a culture of psychological safety in healthcare settings is imperative, yet it’s often overlooked as part of an organization’s efforts to support the mental health of its employees. Often, employers fail to fully grasp what psychological safety truly means or to recognize its role in mental health and achieving organizational objectives. However, psychological safety can be an impactful tool in promoting employee well-being; supporting diversity, equity, and inclusion (DEI) initiatives; improving productivity, spurring innovation, and helping to meet other important goals.
What Is Psychological Safety in Healthcare?
Psychological safety means creating a work environment where staff members feel safe to express their thoughts and concerns without fear of criticism or punishment. This is especially important in hospitals, clinics, and other healthcare settings where speaking up about a mistake or a problem can prevent harm to patients and improve care.
When healthcare workers feel psychologically safe, they are more likely to share ideas, report errors, and work together effectively, which helps everyone, including patients, receive better and safer healthcare services.
The Impact of Psychological Safety on Healthcare Workers
Healthcare workers who experience psychological safety in the workplace are more engaged and tend to have lower rates of absenteeism and presenteeism.
In fact, employees who feel safe to speak up in the workplace and take risks without fear of being blamed or criticized report feeling 2.1 times more motivated, 2.7 times happier, and 3.3 times more enabled to reach their full potential at work, according to a 2024 report by Boston Consulting Group.
Conversely, an absence of psychological safety in healthcare can amplify mental health issues among staff, heightening the risk of job-related errors, injuries, workplace violence, and safety infractions. This environment not only undermines employee retention but also leads to higher turnover rates.
A survey on psychological safety in the workplace confirms this, reporting that 12% of employees with the lowest levels of psychological safety said they were likely to quit within a year.
Such outcomes pose significant risks to an organization’s financial health, patient retention, overall reputation, and brand integrity across all industries.
Psychological safety in healthcare also plays a vital role in employee well-being and is essential for successful DEI efforts. By establishing a psychologically safe workplace, leaders can reduce mental health disparities linked to gender, race, socioeconomic status, LGBTQ+ identity, and other factors.
This supportive environment helps bridge persistent wage and education gaps and reduce career advancement disparities prevalent in healthcare organizations. For example, despite women constituting about 77% of all U.S. healthcare jobs, significant gender pay gaps persist.
According to research published in “Health Affairs Scholar,” the gender wage gap in healthcare is notably severe among advanced practitioners, with women earning only 68% of what their male counterparts make. Similarly, female physicians face a 70% wage gap compared to male physicians.
Psychological safety empowers minority group members to voice their needs and pursue opportunities for advancement, thereby fostering a more equitable and inclusive work culture.
From a patient safety perspective, a lack of psychological safety among healthcare workers can lead to excessive self-censorship, underreporting of errors, and a reluctance to adopt new procedures or question outdated practices. On the contrary, a psychologically safe environment encourages reporting of near misses, nurturing a culture of continuous learning and improvement by allowing team members to acknowledge their mistakes and transform them into valuable lessons.
This, in turn, supports a culture of continuous improvement, and promotes resilience among healthcare workers, thereby enhancing patient care and staff satisfaction.
Regulatory and Legal Requirements in Healthcare
The importance of psychological safety in healthcare is underscored by various regulatory requirements. For instance, the Occupational Safety and Health Administration (OSHA) dictates that all workers have the right to a safe workplace and employers must provide a workplace free from recognized hazards, including those that could lead to psychological harm. The International Organization for Standardization's ISO 45003, meanwhile, offers guidance on managing psychological risks within health and safety management systems, essential for healthcare organizations committed to holistic safety approaches.
In regions like California, legal definitions of workplace violence now encompass psychological trauma and stress, mandating healthcare facilities to implement comprehensive violence prevention plans that include reporting, training, and supporting healthcare workers following incidents of workplace violence.
Strategies for Enhancing Psychological Safety in Healthcare
Discussing sensitive subjects like mental health can be challenging for many. However, it’s crucial for healthcare leaders to embed the principles of psychological safety within their organization’s mental health strategy. Tailoring communication to suit various departments and roles within the healthcare setting is essential.
Potential areas of focus might include:
Occupational Health and Safety Leadership
Healthcare leaders should articulate the risks of neglecting psychological safety and integrate these considerations into overall safety and wellness initiatives. This could include adapting communication during onboarding, ongoing training, and routine safety briefings to emphasize psychological well-being.
For example, during onboarding, new hires can be introduced to a culture of psychological safety through scenarios that encourage speaking up about patient safety concerns. Ongoing training can include case studies that highlight the positive outcomes of psychological safety, such as reduced medication errors or improved patient satisfaction scores. Routine safety briefings might emphasize the importance of mental health support and resources available to staff.
DEI Initiatives
Leaders should leverage diversity, equity, and inclusion programs to bolster psychological safety across diverse employee groups.
Initiatives might include workshops that address mental health disparities affecting specific groups, such as minority nurses or foreign-trained providers, and discuss strategies for equitable treatment. By promoting a dialogue about these disparities, organizations can address systemic issues such as disparities in career advancement and cultivate a more inclusive work environment.
Senior Leadership and Management Engagement
Top-level commitment is crucial in normalizing psychological safety within the healthcare environment. Leaders and managers should model behaviors that promote an open and supportive atmosphere.
For instance, senior medical staff could share personal experiences of learning from mistakes without fear of retribution, thereby fostering a culture where junior staff feel safe to discuss their own concerns. Integrating psychological safety into strategic planning might involve setting clear metrics for reducing incidents of workplace stress and burnout and reporting on these metrics regularly.
Human Resources Initiatives
HR professionals should lead by example, making psychological safety a cornerstone of workplace culture.
This might involve developing feedback mechanisms that are anonymous and easy to use, ensuring staff feel safe to express concerns about workplace dynamics or patient care issues without fear of repercussion. Training programs could be designed to enhance emotional intelligence, particularly for roles with high patient interaction, teaching skills in empathy, active listening, and conflict resolution to improve both patient and staff relationships.
By actively promoting psychological safety, healthcare organizations can enhance employee engagement, reduce absenteeism, improve employee safety, and foster a culture that supports high-quality care. As healthcare continues to face increasingly complex challenges, nurturing an environment where staff feel safe and supported is more critical than ever.