I Mark Raven, here, my upcoming book, the mistakes that make us
in the book, I share insights and strategies for cultivating,
a culture of learning Improvement and Innovation a
place where mistakes are embraced as opportunities for
growth and punishment is recognized as counterproductive
to learn more about the mistakes that make us.
Visit mistakes, book.com, hi, it's Mark.
Gray been here. This is episode 3, 30 of lean
blog. Aw Audio.
Today, I'm reading a post that I wrote and published May 9th
2023. It's actually not published at
lean blog dot org. This is a post that was
published on the value capture website at Value capture
llc.com. You can look for a link in the
show notes or you can go to lean blog dot org, slash audio 3:30
and that will actually forward to the value capture site.
And the blog post, it's titled organizations cannot solve
problems. Unless the leaders admit them
and help others feel safe. Speaking up, This is post number
two in a series that's being published this week at the value
capture website in collaboration with DeAndre award owl.
It's a new hashtag root cause racism series and we invite you
to check that out. So here's the post as we explore
Concepts, like psychological, safety and diversity, equity,
and inclusion, and accessibility, or D EI in this
blog post series, I'd like to kick things off with a look at
some serious problem, statements that we must address.
Yes, I'm thankful for the organizations, including value
capture clients, who aim to close these performance gaps and
systematic and sustained ways in 2023.
Healthcare organizations face, a number of serious problems.
For one patients, continue to be harmed at unacceptably.
High rates not because of quote unquote bad providers but as the
result of preventable errors that are caused by process
problems and miscommunications. Additionally, Healthcare
professionals are injured at rates far higher than in
industries that are perceived as dangerous.
Such as mining or manufacturing. As to chart in the blog post,
shows driven by OSHA data. There's quite a gap or hospitals
are as dangerous. If not more dangerous nursing
care and skilled nursing facilities, the same.
They are both more dangerous than the average of what's
called all private. History by OSHA for measures
such as various types of patient harms including pressure, ulcers
Falls, and hospital-acquired infections, and employee
injuries and lost work days. We need to define the measurable
gaps between the current levels of performance and the
theoretical limits. Meaning, zero harm.
It's not just the averages that matter but the variation.
Nobody should get hurt at work. But how can we identify
inequities in health outcomes? Outcomes and employee safety
data. With the aim of providing
equally safe conditions for all if organizations and their
senior leaders cannot openly admit serious problems, like a
patient or employee harm. How can they expect Healthcare
professionals to speak up about the problems and causes of harm
that they see and experience? If people are going to choose to
use their voice, we need to eliminate the two primary
barriers as discussed by Ethan Burris PhD, from the University
of Texas at Austin. Often these two primary barriers
are fear and futility. If people fear punishment, they
won't speak up. Even if the Fear Factor is
reduced, people will stop speaking up if they think doing.
So just isn't worth the effort that's futility.
Now, others in the series will discuss this concept and it's
practical implication. So let's start with the
definition of psychological safety.
To get us on the same page. One such definition is by
Timothy our Clark PhD author of the book.
The four stages of psychological safety.
He defines it as being psychological.
Safety is a social condition in which you feel included, safe to
learn safety contribute, safe to challenge the status quo, all
without fear of being embarrassed, Most marginalized
or punished in some way, you can take a deeper dive in the
psychological safety, through a value captures resources page,
that's linked to in the blog post.
Research by Amy Edmondson. PhD from Harvard, Business
School has demonstrated that teams with the highest levels of
psychological safety improve more and perform better.
Whether that's within a tech company like Google or a
healthcare organization and Healthcare teams, having a
higher feeling of psychological. Safety means individuals are
more likely to speak up about risks problems, mistakes,
near-misses? Or or harm?
We cannot solve problems unless we know what they are. up about
a near-miss means that future harm can be prevented When
leaders can reduce fear, people will feel safer about speaking
up. That's the Fear Factor that must
be followed up then with effective problem solving.
So speaking up about a mistake means it won't be repeated.
We reduce the futility Factor as well how do leaders create
conditions for people to feel psychologically safe?
Well, they cannot declare in organization or some part of it
to be a safe space. They must demonstrate that it's
actually safe to speak up without the fear of or the
Reality of punishment. It's neither Fair nor effective
to demand that Healthcare professionals, be brave, or
courageous or that. It's their professional
obligation to speak. Truth to power, when fear
exists, people will protect themselves by choosing to stay
silent. That's their right.
And it's understandable, that's why L must work to reduce the
level of risk. Shifting from punishing, those
who speak up to instead rewarding and celebrating them
for doing so. As Clark teaches leader, set the
tone through, not just their words, but their actions, those
actions include two high-level countermeasures one modeling?
Vulnerable acts and to rewarding vulnerable ads as Clark says, a
vulnerable Act is one that exposes us to the risk of harm
or loss personally or professionally writing a blog
post. Like this is a vulnerable act in
the sense that an author might say the wrong thing that pens
and they might hurt their professional reputation by
writing something that's unclear.
Any human interaction is on some level of vulnerable act.
If we don't feel a low level of risk or zero risk, then our
leaders and colleagues can work to help us feel safer over time.
Other examples of vulnerable acts mapped to Clarks.
Four stages model are shown in a table stage.
One inclusion safety sharing a personal problem or challenge is
An example of a vulnerable at stage 2, Learners safety.
Sharing past mistakes is also an example of a vulnerable act
stage, three contributors safety communicating.
Bad news, is also an example of a vulnerable act and stage four
Challengers safety. Inviting others to challenge.
Your opinion is an example of a vulnerable Act.
Now because of their leadership position, these acts are
generally less vulnerable or less risky to a more senior
leader leading. By example, gives others
permission to follow some acts such as actively.
Inviting disagreement, debates or dissent, directly give people
permission to use their voices, but people might still be
afraid, especially if speaking up, was punished by previous
leaders telling people, they should now feel safe.
Doesn't mean they will immediately Feel safe.
If a leader has admitted a mistake or close disclose that
they don't know. Something team members might
test the waters in a small way that doesn't feel horribly
unsafe when employees mirror. Those vulnerable acts are
respond to the invitation to speak up leaders, must reward
them for doing so. And Clark's model teams and
organizations. Generally progressed through the
four stages of psychological safety, the ultimate level the
most difficult for a team to achieve would be stage for
Challenger safety. Where people feel safe
challenging, the status quo, this is where Improvement and
Innovation happen, but it's hard for people to feel safe
challenging, the status quo if they don't feel first included,
accepted and respected by their colleagues and leaders.
Stage one of inclusion, safety is closely connected to
diversity equity and inclusion accessibility or D eia, and
belonging goals practices and initiatives.
If all employees don't feel equal levels of inclusion,
safety due to gender race, ethnicity sexual, orientation,
or other distinguishing characteristics, then we can't
expect them to feel equally safe to learn, contribute and
challenge the status quo. If employees from different
demographic groups, don't feel equally included, they would
feel less welcome to ask questions unless safe to
challenge the status quo. This means that staff safety and
patient, safety and their departments will suffer as an
article. I've linked to says the main
stressor, many black women face is a lack of psychological
safety as a Forbes article. That I've also linked to says
frustratingly black women also ranked dead last in their
experience of manager support. manager showing interest in
their career, checking in on their well-being, and promoting
inclusion as compared to survey results that were grouped by
other identities, including men all women, lgbtq women women
with disabilities, white women, Asian, women, and Latinas, And a
healthcare organization if leaders are committed to equity
and employee safety and in health outcomes.
I suggest asking the following questions, one are there
disparities in patient safety measures or other health
outcomes based on these demographics to are there
disparities and employees. Safety metrics, including lost
workday incidents based on demographics.
Three our employee safety disparities caused to what
degree by the type of Of work being more physically demanding
or caused by some employee groups, feeling less safe to
speak up and I'll add like the work being more physically
demanding is not an excuse for higher injury rates, that would
be part of our challenge. Question 4.
What can we do to reduce gaps in the feeling of psychological
safety across teams or demographic groups and 5.
What hypotheses can we test? And how would we gauge our
progress? So as we kick off this blog
series, I look forward to the contributions from our varied
and diverse contributors. I'm also eager to hear thoughts
comments questions and experience from our audience
here in the blog here, listening to the podcast and on social
media. So, thanks for reading.
And this case, thanks for listening.
Thanks to Value capture and their leaders for sponsoring
this series. Thanks to Geo and reward Del for
her guidance and collaboration and thanks to everybody who has
contributed. I'm so again, you can go to lean
blog Dot orgs. Audio 330 it will forward you to
this blog post. And you can also find a link at
the bottom of the post on to register for a panel discussion
webinar that I'm going to be part of the other five blog
series writers are going to be contributing to this panel
discussion to be held on May 16th 1:00 Eastern.
It's titled getting 20 harm for patients and staff with DEA and
psychological safety Concepts. Again, it's a free panel
discussion format webinar for about 90 minutes.
Hope you'll come register again. You can find the link at lean
blog dot org, slash audio 330 or you can go to Value capture
llc.com slash webinars. It's titled getting 20 harm for
patients and staff with DEA and psychological safety Concepts.
Again, it's a free panel discussion format webinar for
about 90 minutes. Hope you'll come register again.
You can find the link at lean blog dot org, slash audio 330 or
you can go to Value capture llc.com slash webinars.