“Feeling safe enough to express yourself in the workplace” – behaviours to support psychological safety

In 2005 my late wife Elaine, mum to our two young children, died during an attempted operation. A skilled clinical team were overcome when an unexpected complication arose while she was anaesthetised. Three doctors were unable to identify the specific problem, what it meant and what they needed to do. In short, they didn’t have “situational awareness”. Elaine never regained consciousness and died 13 days later.

During the emergency, the three doctors were supported by two nurses and two anaesthetic assistants (ODP’s). To quote from the Inquest, these four staff “knew exactly what needed to happen but didn’t know how to broach the subject”. They could see what was going wrong, they had “situational awareness”. They used their initiative to prepare life-saving equipment and made subtle suggestions to the doctors about what needed to happen, but the doctors did not hear them – the message never got through.

This wasn’t a failure of the nursing & ODP staff. They were unable to speak up because they feared ridicule, being ‘told off’ or even being disadvantaged in the future for sharing their thoughts to more senior people. In other words, they did not have ‘psychological safety’.

Mistakes are normal. In Elaine’s case the doctors made fatal errors. Yet people around them held the key to success and getting it right. For leaders, accepting your fallibility is essential, being confident in your abilities yet knowing you will still make mistakes, is what we call confident humility. Seeking the ideas, thoughts and support of others to reach optimum outcomes, especially in complex and capacity sapping situations is critical.

Make it easy for others to do the right thing. The science of human factors tells us to develop systems, processes and behaviours that reduce the probability or severity of errors. This approach has made other safety critical industries much safer. Behaviours that create psychological safety make it easier to get things right.

Psychological safety. Leaders at all levels require situational awareness, i.e. understanding what’s happening, what it means and what to do about it. Your team, your colleagues and the frontline often have clearer information and ideas. People will only share information if they feel safe to do so and they trust you to listen and use that information wisely and ethically. When leaders create psychological safety they become more effective and are more likely to reach optimum outcomes; avoiding outcomes that may otherwise be derailed by unintended consequences.

The types of behaviours Leaders can adopt:
· Ask open questions, (what?, why?, how?, who?), listen, don’t respond, demonstrate understanding
· Focus on what’s right, not who’s right
· Praise people who share information, ideas, concerns with you, even if it’s uncomfortable

The types of behaviours all of us can adopt:
· Present facts and evidence clearly, label opinions and ideas as opinions and ideas – “I think”
· Be assertive when presenting personal feelings and concerns – “I feel”
· Resolve uncertainty and ambiguity wherever possible.