Primary Author: | Gina Aranzamendez, MSN, RN-BC |
Co-Principal Investigators/Collaborators: | Debbie James, MSN, RN, CNS, CCRN |
Organization: | MD Anderson Cancer Center |
Abstract
Purpose
To review the literature on psychological safety in healthcare care setting, more specifically, to identify environmental climate that promotes and supports psychological safety in healthcare organizations.
Background
Quality improvement in healthcare has been underscored since the Institute of Medicine (IOM) published its landmark report; To Err is Human, (IOM, 2000). One of the central tenets of quality improvement is the belief that people are forthcoming and honest about quality issues. There is evidence to suggest that psychological safety leads to organizational learning, team engagement and team effectiveness, which in turns leads to positive outcomes. Psychological safety is described as one's perception of consequences for taking interpersonal risk in their work environment. With the increasing and ever changing demands in healthcare, it is imperative to gain a better understanding of the factors that foster psychological safety to increase organizational capacity to change and enhance the quality and safety of patient care. Interpersonal climates that elicit a belief about the social consequences of speaking up about sensitive topics like errors are silent but potent barriers of any improvement initiative.
Materials & Methods
Integrative literature search and review.
Results
Two major themes were identified in this study, leadership behavior and network ties. Leadership behaviors were further divided into subcategories: leadership inclusiveness, change-oriented behavior, trustworthiness, and ethical leadership. The behaviors of leaders played a critical role in promoting psychological safety.
Conclusion
The findings show the complex dyadic interplay between leaders and team members. The current literature supports the significant role of leaders as one of the major contextual influences in promoting psychologically safe environment. Specific leadership behaviors found in this review, leadership inclusiveness, trustworthiness, change-oriented leaders, and ethical leadership can foster psychologically safe environment. The development and training of such leaders must incorporate cultivation of the different domains of leadership. Knowledge of the factors influencing psychological safety will assist healthcare organizations to cultivate and promote the psychological safety among healthcare personnel thereby promoting patient safety and increasing healthcare quality.
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© Improvement Science Research Network, 2012
The ISRN published this as received and with permission from the author(s).