Psychological safety, AKA a culture of safety, represents one's comfort in speaking up in the name of safety.This article in the American Journal of Infection Prevention neatly explores a snapshot of psychological safety, as assessed by questionnaire, across multiple U.S. hospitals and correlates that with hospital self reported infection prevention processes. Nearly 60% of 900 hospitals responded to the survey, which is no small matter.
A couple of things of note: Only 41% of hospitals reported the presence of a hospital epidemiologist in the facility! This is not surprising as most community hospitals do not have a formal hospital epidemiologist on staff. Only 38% of respondents reported a "high psychological safety" environment within the workplace. High psychological safety was associated with more successful use of urinary catheter discontinuation orders and nurse driven urinary catheter discontinuation. Most likely, these healthcare workers feel more empowered to act in the name of safety.
So here is my take- a true culture of safety starts with relentless messaging from the senior leaders that safety is first and foremost. This is followed by a reporting mechanism with action oriented responses to hold systems and individuals accountable. Anything less is suboptimal.
Patient safety trumps patient throughput.
