Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Leaders who elevate diverse employees create psychological safety

Nicola F. De Paul, PhD
Policy
December 15, 2022
2 Shares
Share
Tweet
Share

When I transitioned into a new role as a training faculty member at an academic medical center a few years ago, it didn’t take long to realize that the program had a problem with psychological safety. There wasn’t much.

As I got to know the trainees and heard specific feedback, I began to understand why. The trainees felt criticized and unsupported by the training faculty. And every time there was a faculty meeting, rumors circulated about trainees’ poor performance, which led them to worry about being failed out of the program. As I developed relationships with the training faculty, it became clear that staff members felt as unsafe as the trainees.

Everyone was impacted by cultural habits that promoted indirect communication, over-emphasized “growth areas,” and limited power sharing between those without titles.

After observing for several months, I decided to act and provide direct feedback to the training director and the department chief. I shared my concerns about the program’s cultural practices. I recommended various changes to promote psychological safety and a learning environment where trainees could be sufficiently supported to learn, grow, and spread their wings as developing medical professionals.

My feedback was met with resistance. Leadership was taken aback by my concerns and unwilling to consider my recommendations. I was initially told that I was dead wrong, “that’s not happening.” So, nothing changed. Nothing changed until a complaint was filed, and the program’s governing body initiated an investigation. The external scrutiny and feedback motivated the program’s leadership to let go of the most problematic cultural practices, such as discussing trainees’ foibles in all staff meetings without providing behaviorally specific feedback to trainees first.

I don’t know if hearts and minds were changed, but the implementation of these modest changes improved psychological safety. Over time trainees reported feeling more supported, and faculty meetings took on a more civil tone with less opportunity for backbiting or criticism of the least powerful. Everyone felt safer. Changing the program’s training policies and communication practices profoundly impacted psychological safety for trainees and faculty in the training environment.

Leaders in health care environments often fail to recognize their role in creating psychological safety and consider building it as something that can be accomplished by giving a presentation on high-reliability principles at their quarterly staff meetings.

A failure to create psychological safety for the least powerful in the system is a failure of leadership. A lack of psychological safety for employees increases physical safety risks for patients.

Leaders have the power to shape expectations and create psychologically safer environments in health care. Leaders are responsible for setting the tone for respectful and safe communication practices. But the work to create psychological safety must start within. Health care systems need courageous leaders willing to self-reflect and acknowledge the unintended impacts (and harms) their workplace policies and communication practices have on our employees, health professions trainees, and patients.

We have made creating psychological safety overly complicated.

To create lasting psychological safety in health care systems, senior and executive leaders need to do three things: elevate historically lower power and diverse employees to the decision-making table, give extra weight to the needs and perspectives of these employees, and respond with systemic policy changes that address these employees’ needs in courageous ways.

When we create a safer and more supportive environment for our lowest-power employees, we create an environment where all employees thrive. And we create a safer environment for patient care. Everyone wins, and we create a resilient system that is a pleasure for health care leaders and our diverse employees to work in.

We all deserve to work in an environment where every person in our health care system, from the housekeeping and maintenance employees to the CEO, feels valued, honored, and safe. Let’s get to work.

Nicola F. De Paul is a clinical psychologist and a health systems leadership consultant.

Prev

Ethical consumerism: How to shop responsibly for the holidays 

December 15, 2022 Kevin 2
…
Next

Nutrition's impact on pain and obesity [PODCAST]

December 15, 2022 Kevin 0
…

Tagged as: Hospital-Based Medicine, Practice Management

Post navigation

< Previous Post
Ethical consumerism: How to shop responsibly for the holidays 
Next Post >
Nutrition's impact on pain and obesity [PODCAST]

More by Nicola F. De Paul, PhD

  • 5 questions C-suite leaders must be willing to ask to address burnout and create thriving health care organizations

    Nicola F. De Paul, PhD

Related Posts

  • When physician leaders get acquired and squeezed

    Anonymous
  • What does curiosity have to do with patient safety?

    Elizabeth Lerner Papautsky, PhD
  • COVID-19 proved that diverse voices make health care better

    Naprisha Taylor
  • Does medical school train students to become managers or leaders?

    Maria Yang, MD
  • It’s time for presidential candidates to debate the safety of pharmaceutical products

    Steven Reznick, MD
  • An important health care safety net is at risk

    Mark Pappadakis, DO

More in Policy

  • Physician well-being: Overcoming administrative hurdles

    Pat Rich
  • Health care’s hidden problem: hospital primary care losses

    Christopher Habig, MBA
  • From fishing licenses to gun control

    Mitch Bruss, MD
  • How the NFL offers a window into health care solutions for our country

    Renee Hsia, MD
  • Unlocking the potential of allied health roles for a thriving health care system

    Eric Stastny, MHA
  • Efficient staffing partners for health systems

    Patrick Dotts
  • Most Popular

  • Past Week

    • Health care’s hidden problem: hospital primary care losses

      Christopher Habig, MBA | Policy
    • The dark role of science, medicine, and tasers

      L. Joseph Parker, MD | Physician
    • Catastrophic failure of educational leadership can affect medical students

      Arthur Lazarus, MD, MBA | Education
    • The synergy of AI and human intelligence in transforming health care

      Harvey Castro, MD, MBA | Tech
    • Coping with grief in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Navigating physician shortages in rural communities

      Stacy Wentworth, MD | Physician
  • Past 6 Months

    • Medicare coverage saves lives. Enrolling shouldn’t be this complicated.

      Catherine L. Chen, MD, MPH | Physician
    • Emergency department burnout: a cry for change

      Anonymous | Conditions
    • Health care’s hidden problem: hospital primary care losses

      Christopher Habig, MBA | Policy
    • The erosion of compassion in medicine

      Daniel Luger, MD | Education
    • Pain medicine realities: beyond the opioid crisis

      Richard A. Lawhern, PhD and Stephen E. Nadeau, MD | Conditions
    • When medical protocol meets family concerns

      Richard Young, MD | Conditions
  • Recent Posts

    • Catastrophic failure of educational leadership can affect medical students

      Arthur Lazarus, MD, MBA | Education
    • Unraveling the mysteries of mast cell disorders [PODCAST]

      The Podcast by KevinMD | Podcast
    • How to select the right mutual funds for your goals

      Amarish Dave, DO | Finance
    • America’s pain management nightmare: How the DEA shaped the opioid epidemic

      L. Joseph Parker, MD | Physician
    • The middleman dilemma in health care

      Anonymous | Physician
    • Tips for success as a plastic surgeon [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Nurses, Med Student Slashed; Deadly Tick Disease Outbreak; COVID Vax After Infection
  • ASCT Tops CAR T-Cell Therapy for Relapsed LBCL in Complete Remission
  • 'New Gold Standard' for Previously Untreated CLL
  • Emicizumab Safe, Effective, in Infants With Hemophilia A
  • Add-On Inavolisib Ups PFS in PIK3CA-Mutated Breast Cancer

Meeting Coverage

  • ASCT Tops CAR T-Cell Therapy for Relapsed LBCL in Complete Remission
  • Frontline Venetoclax-Ibrutinib for CLL Boosts Survival in Fit Patients
  • Emicizumab Safe, Effective, in Infants With Hemophilia A
  • Add-On Inavolisib Ups PFS in PIK3CA-Mutated Breast Cancer
  • Lovo-Cel 'Life-Changing, Transformative' in Sickle Cell Disease
  • Most Popular

  • Past Week

    • Health care’s hidden problem: hospital primary care losses

      Christopher Habig, MBA | Policy
    • The dark role of science, medicine, and tasers

      L. Joseph Parker, MD | Physician
    • Catastrophic failure of educational leadership can affect medical students

      Arthur Lazarus, MD, MBA | Education
    • The synergy of AI and human intelligence in transforming health care

      Harvey Castro, MD, MBA | Tech
    • Coping with grief in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Navigating physician shortages in rural communities

      Stacy Wentworth, MD | Physician
  • Past 6 Months

    • Medicare coverage saves lives. Enrolling shouldn’t be this complicated.

      Catherine L. Chen, MD, MPH | Physician
    • Emergency department burnout: a cry for change

      Anonymous | Conditions
    • Health care’s hidden problem: hospital primary care losses

      Christopher Habig, MBA | Policy
    • The erosion of compassion in medicine

      Daniel Luger, MD | Education
    • Pain medicine realities: beyond the opioid crisis

      Richard A. Lawhern, PhD and Stephen E. Nadeau, MD | Conditions
    • When medical protocol meets family concerns

      Richard Young, MD | Conditions
  • Recent Posts

    • Catastrophic failure of educational leadership can affect medical students

      Arthur Lazarus, MD, MBA | Education
    • Unraveling the mysteries of mast cell disorders [PODCAST]

      The Podcast by KevinMD | Podcast
    • How to select the right mutual funds for your goals

      Amarish Dave, DO | Finance
    • America’s pain management nightmare: How the DEA shaped the opioid epidemic

      L. Joseph Parker, MD | Physician
    • The middleman dilemma in health care

      Anonymous | Physician
    • Tips for success as a plastic surgeon [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leaders who elevate diverse employees create psychological safety
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...