A key part of organizing for high reliability includes a focus on continuous learning. We rely on inviting and giving feedback, and respecting the voices of all of our associates and providers as we create our culture of One Safety. We are responsible for speaking up when problems arise by asking questions, questioning answers and sharing our observations and recommendations. When others are intimidated by us because of our position/title, body language, and/or verbal communication, they may not feel comfortable speaking up, and this can result in harm for ourselves and others that we could have prevented. The harm caused can be physical (e.g., a patient fall), but failing to create a safe environment where others can speak up can cause mental and emotional harm in the form of stress and an unhealthy work environment, too.
What is Psychological Safety?
We each must feel psychologically safe to speak up and share our opinions and knowledge. Psychological safety can be defined as “being able to show and employ one’s self without fear of negative consequences of self-image, status or career” (Kahn 1990, p. 708). In psychologically safe teams, team members feel respected and accepted.
High Reliability Organizing (HRO): Tones
By applying the HRO tones to reduce power distance and level authority gradients we can create caring, trusting and respectful relationships with others that allow timely and honest communication. These tones should be the routine way that we interact with our patients and each other.
We can improve patient and associate safety by making it easy for others to speak up and interact with us by practicing the following behaviors:
- Smile and greet others (eye contact, say hello)
- Refer to others by preferred (usually first) name
- Listen with empathy and intent to understand
- Provide opportunities for others to ask questions