6 questions to ask about your team’s psychological safety

By Dr. Tejal Gandhi, Chief Safety and Transformation Officer, Press Ganey; and Dr. Jeff Doucette, Chief Nursing Officer, Press Ganey.

We view zero harm as a nonnegotiable goal, as patients have a right to expect safe, high-quality care, and caregivers have a right to be enabled to deliver it. The pursuit of zero harm is a never-ending, constantly evolving challenge, and success is predicated on the critical component of a culture that fosters psychological safety. 

Given the recent high-profile court case criminalizing errors in healthcare and given the context of the current healthcare landscape, where health systems and their people are under tremendous strain, there has never been a more important time for leaders to pause and ask themselves these challenging questions:

• Do we consistently reinforce our safety mission and our shared commitment to the goal of zero harm for patients and the workforce?
• Have we made the right investments to foster safety culture that encourages reporting and allows us to identify and learn from safety events to drive improvement? Are we monitoring trends in event reporting to detect meaningful shifts?
• Have we taken steps to embed and sustain high reliability principles and practices at all levels of the organization, with an emphasis on having the right controls and protocols to ensure adherence to best practices?
• When harm occurs, do we have robust processes to ensure support, communication, and resolution with our patients as well as a process to care for the caregivers involved?
• Do we have an up-to-date pulse on state of engagement and safety culture among our workforce and providers? 
• Do we provide a support system for staff to reduce burnout and build resilience? 

Press Ganey has a 20-year history of facilitating safety culture transformation. Fair and Just Culture training and coaching has been a mainstay of our approach, and it is an essential element in system design that anticipates our propensity to drift.

The pursuit of zero harm is an ongoing journey, and every day will bring about conversations on how we move forward as an industry and advance our shared commitment to the goal⁠. We encourage healthcare leaders to maintain open dialogue with staff, to model psychological safety, and to stay true to the methods, skills, and leadership practices of high reliability to advance the industry toward zero harm.