Abstract
BackgroundPsychological safety is a dynamic team-level phenomenon which exists when team members believe that it is safe to take interpersonal risks. In healthcare teams, the presence of psychological safety is critical to delivering safe care. Scholars have highlighted a need for alternative measures which compliment survey-based measures of psychological safety in healthcare teams.MethodsThe exploratory phase of this study raised concerns about whether current survey measures could provide a sufficient understanding of psychological safety within healthcare teams to inform strategies to improve it. Thus, previously validated psychological safety surveys and a meeting observation measure were adapted for use in healthcare teams. First, two group feedback sessions were held with 22 healthcare professionals, as well as a systematic literature review. Then, the members of eleven healthcare teams in Ireland and The Netherlands (n = 135) took part in the pilot test of the adapted composite measure.ResultsThe final composite measure has two parts: a team meeting observation measure and an adapted survey. The observation measure has 31 observable behaviours fitting seven categories: voice, defensive voice, silence behaviours, supportive, unsupportive, learning or improvement-oriented and familiarity type behaviours. The survey part consists of 19 items in three sub-dimensions related to; the team leader, other team members and the team as a whole. Three additional items capture the perceived representativeness of the observed team meeting compared to other similar meetings. Final adaptations were made in order to integrate the observation and survey measure.ConclusionsThe resulting composite measure combines the strengths of observational and survey measures and is tailored for use in healthcare teams. It is uniquely co-developed with healthcare professionals and grounded in the psychological safety and healthcare literature. This composite measure can enable longitudinal research on psychological safety and inform future research to develop and test interventions to improve psychological safety.
Highlights
IntroductionResearcher introduced the concept of psychological safety and gave examples relevant to healthcare settingsHealthcare professionals gained an understanding of psychological safety and the role it plays in teams.Measurement developmentEach participant was given items from six previously validated psychological safety scales (see Table 1)
Researcher introduced the concept of psychological safety and gave examples relevant to healthcare settingsHealthcare professionals gained an understanding of psychological safety and the role it plays in teams.Measurement developmentEach participant was given items from six previously validated psychological safety scales
The present study aims to add to the existing body of literature by adapting current observational and survey measures, in collaboration with healthcare professionals, to provide a triangulated approach to measuring psychological safety at the team and individual level
Summary
Researcher introduced the concept of psychological safety and gave examples relevant to healthcare settingsHealthcare professionals gained an understanding of psychological safety and the role it plays in teams.Measurement developmentEach participant was given items from six previously validated psychological safety scales (see Table 1). Participants were invited to build their own measure of psychological safety by choosing the items they felt, based on their experience of working on healthcare teams, were most relevant. They could make any changes to the wording of items and add any relevant questions they felt were missing. Psychological safety is fundamental to effective teamwork, communication, and collaboration at work It is “a team level phenomenon where all team members believe they are safe to take interpersonal risks” Being able to assess changes in psychological safety over time is important as healthcare teams adapt to the challenges of the pandemic through developing new collaborative practices and evolving models of care delivery
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