What Is Psychological Safety and Why Do You Need It in Your Hospital?

Veterinary teams are taught to advocate for their patients. They are instructed to be the voices for those who cannot speak. But how does one accomplish this if they are fearful of retribution or humiliation? These kinds of workplace cultures lack psychological safety. A psychologically safe space enables individuals to be curious, ask questions, and admit mistakes. The presence of psychological safety in veterinary hospitals can have an array of benefits, including improved team member retention,¹ job satisfaction,² and patient health outcomes.³

What Is Psychological Safety?

The ability to comfortably ask questions, offer suggestions, and be vulnerable within a group without fear of humiliation or retribution is one of the fundamentals of psychological safety.⁴ Within a psychologically safe environment, individuals experience trust, mutual respect, and care and concern for their teammates.⁴ Psychological safety relies on the secure belief that vulnerabilities or curiosity will not be met with a negative reaction.⁵

To prevent misunderstanding, it is also important to define and identify what psychological safety is not. Although the ideal outcome of a psychologically safe workplace culture is a collaborative and engaged team, psychological safety is not defined as being nice, having mutual liking, or displaying a sparkling personality. Most importantly, psychological safety does not mean a team that is in absolute agreement or a conflict-free environment. Conversely, it means cultivating a culture of “honesty, openness, and sincerity.”⁶ Within this environment, disagreements can spark innovation and opposing ideas are met with “candor, openness, and mutual respect.”⁶

Additionally, psychological safety does not require individuals to compromise on performance or standards. Obtaining and maintaining high standards are of paramount importance in hospitals. It is possible to employ psychological safety while continuing to advocate for appropriate care for patients. By fostering mutual respect, teams can learn, improve, and advance the profession.

Lastly, the role of psychological safety is not interchangeable with trust. These differing concepts are experienced at different levels. As an example, Edmonson says “trust is about giving others the benefit of the doubt” while “psychological safety relates to whether others give you the benefit of the doubt when you have asked for help or admitted a mistake.”⁴

How to Promote a Psychologically Safe Space

Similar to the treatment of patients, creating a psychologically safe workplace requires a multimodal approach. Creating this culture begins with a foundation of encouraging open dialogue. Expressing a genuine interest in team members’ or peers’ ideas allows individuals to feel valued. Critically important to this process is the role of knowledge sharing. By providing all team members with a way to transparently share information, team training and growth have the ability to prosper. Knowledge sharing can be achieved via platforms such as Slack, SharePoint, or Google Docs.

While achieving a psychologically safe workplace requires effort from every level of the organizational chart, leadership plays a foundational role. Research shows that an inclusive leader who “invites and appreciates” their team’s ideas, suggestions, and/or contributions is essential in creating a climate for learning.⁷ Inclusive and active leadership positively impacts meaningful team engagement.⁷ Beyond the role of leadership, BOX 1 lists additional actions that can foster an environment of psychological safety in the veterinary workplace.

How to Recognize Damage to Psychological Safety

Appreciating the myriad factors that build and support an innovative and curious culture, just 1 or more minimal actions or individuals can harm the integrity of a psychologically safe space. Behaviors such as using angry, passive aggressive, or dismissive language can create barriers to collaboration. In addition, individuals who witness these actions, and are not directly involved, can also contribute to injuries in psychological safety by not reporting it or offering to lend a helping hand or listening ear.³ An environment lacking safety is a psychological danger. These environments are “hostile, oppressive and/or anxiety inducing.”⁸ It is reasonable to assume that individuals in these settings experience fear, stress, and negative health effects, making those workplaces less than optimal spaces to work and provide quality care. To underscore the differences between psychologically safe and dangerous workplaces, TABLE 1 lists common signs of each and TABLE 2 provides examples of behaviors that encourage and discourage psychological safety.

Summary

As a scientific profession, veterinary professionals look for data and evidence to support a reason to use or avoid an intervention for patients. It is fortuitous that the same data and evidence exist to champion processes that promote team retention and improvement through psychological safety. For example, research has demonstrated that a psychologically safe workplace positively influences work engagement,⁹ team learning,¹⁰ collaboration in efforts to improve patient care quality,⁷ and patient safety.¹¹ And research even exists that details the extent of these employee benefits, as seen in TABLE 3.

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