Several years ago when I co-owned and managed a small animal general practice, we hired a newly graduated certified veterinary technician who was enthusiastic about animal care. She brought a zest for learning and a desire to connect with the team. With roughly a year of full-time work in her wake, this CVT \u2014 let\u2019s call her Susie \u2014 was experienced enough to have built confidence and self-efficacy but still green enough to be ripe for growth.<\/p>\n
I find that such a combination can contribute to stumbles. And stumble she did, in a big way.<\/p>\n
I was sitting in the doctor\u2019s office one morning when Susie came running in, ashen-faced and terrified. \u201cI just overdosed that cat!\u201d<\/p>\n
In those days, our surgery team was made up of a doctor and a technician. We liked to leverage our staff members in a way that allowed them to display the full breadth of their skills. For example, the doctor would often order a drug and ask the technician to calculate the dose and administer it. Which is what happened on this day with Susie.<\/p>\n
After completing a procedure on the feline patient, the doctor asked Susie to calculate and inject meloxicam. Susie did, but she made a critical error. Instead of injecting 0.26 mL, the appropriate dose, she pulled up and injected 2.6 mL.<\/p>\n
As soon as she finished the injection, Susie was overcome by terror. Rechecking her calculation, she realized what she had done. Immediately, she bolted into the doctor\u2019s office.<\/p>\n
Intuition tells us that if we populate a team with the smartest, most talented and experienced people, they will excel. Hire the best, get the best. Dr. Amy Edmondson, the Novartis Professor of Leadership at Harvard Business School, says otherwise.<\/p>\n
In her seminal paper, published in 1996 in the Journal of Applied Behavioral Science<\/em>, Dr. Edmondson showed that one variable consistently and strongly predicts the frequency of medical errors in health care teams. It\u2019s what researchers call psychological safety.<\/p>\n Psychological safety is, in essence, the subjective belief that \u201cI will not be punished, admonished or dismissed\u201d if, within \u201cmy team,\u201d I discuss difficult topics, ask for help, admit to a mistake or suggest ideas. We call these interpersonal risks. Think of it as a cultural norm stating, \u201cIn this team, productive candor<\/a> is expected.\u201d<\/p>\n Countless studies done in a wide range of cultures and industries have since shown that the presence of psychological safety is the top predictor of team effectiveness. It\u2019s the secret sauce of the highest-performing teams.<\/p>\n When team members feel comfortable taking interpersonal risks, we see improved outcomes in variables such as well-being, turnover, safety, productivity<\/a>, creativity and innovation, inclusion and belonging, and profitability. Yet, less than half of employees worldwide report feeling psychologically safe in their team.<\/p>\n Which brings me back to Susie.<\/p>\n When I learned about psychological safety in teams, I thought about that day with Susie. What struck me wasn\u2019t that she made a big mistake but that she quickly admitted to it. She was distraught and wholly terrified. She had put a patient\u2019s life at risk and was convinced she\u2019d lose her job. Still, through the fog of fear, she came directly to us. She didn\u2019t try to hide the mistake or make excuses. She fully owned it.<\/p>\n I know now that she reacted that way because she felt psychologically safe. Which led me to consider something more troubling.<\/p>\n In all the years I managed veterinary hospitals, I knew nothing of the concept of psychological safety. It wasn\u2019t until I shifted to consulting work and began my studies for a master\u2019s in applied positive psychology and coaching psychology that I learned about the phenomenon and how to cultivate it.<\/p>\n So, while we had nurtured psychological safety with Susie, had we done so with the other technicians? Our client care team? What about at the other hospitals I was involved with?<\/p>\n How often had a tragic error, gaffe or stumble happened and the team member hid it or covered it up? How often had someone on the team not understood a policy or procedure but, looking around at others who seemed to \u201cget it,\u201d didn\u2019t ask questions? How many times had the team seen a creative solution to a challenge or a better way of doing the work but held back?<\/p>\n When psychological safety isn\u2019t cultivated, nurtured and maintained with intention and consistency, it is bound to falter. Without it, beneficial, sometimes critical, information is withheld. The team\u2019s maximum potential cannot be reached.<\/p>\n Had I failed to uncap the potential of my teams?<\/p>\n We know from research that leaders have the greatest influence on the presence or absence of psychological safety in a team. If a leader models productive candor, the team likely will follow suit. How does a leader do so? In these five steps.<\/p>\n 1. Measure it.<\/strong><\/p>\n We excel at measuring the important financial-performance indicators. This makes us incredibly effective in finances and operations. However, we rarely put much effort into measuring the human experience of our team. We can manage only what we measure.<\/p>\n So, find a way to measure psychological safety in your team, perhaps with a routine survey asking questions like, \u201cDo you believe your opinion matters here?\u201d A Gallup poll found that, on average, only 3 in 10 employees feel that their opinion matters at work. In organizations that double that ratio to 6 in 10, we see a 27% reduction in turnover and a 12% increase in profitability.<\/p>\n 2. Set the stage.<\/strong><\/p>\n With a baseline measurement in hand, now\u2019s the time to make the case to your team. Begin by modeling the vulnerability and honesty you\u2019d like to see. Help everyone understand that you do not have all the answers or solutions.<\/p>\n Teams do best when they are a collective and not a group of individuals directed by a \u201cbig boss in charge.\u201d Plead for everyone\u2019s voice, perspective and ideas. And make clear that mistakes are a normal part of growth and learning. Hiding mistakes benefits no one. Openly sharing and discussing the normal, inevitable human stumbles is precisely how teams improve.<\/p>\nSafety in Numbers<\/h3>\n
How to Cultivate Candor<\/h3>\n