Safety to report. A lead indicator of performance and risk.

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Safety to report.

In defining psychological safety I like to use Dr Timothy Clark’s stepped approach as an explainer: 1. I feel like I belong and am part of a team.  2. I feel safe to learn  3. I feel safe to contribute  4. I feel safe to challenge.   The safety refers to the ability for us as individuals to engage openly and with a degree of vulnerability without the threat of being punished, humiliated or embarrassed. 

Everyone has their story which often starts at school – the humiliation of trying to do the right thing and being called out for being disloyal to friends, a trouble maker or a dobber. Into highschool where you are called a square or a goodie two shoes for demonstrating good behaviour or calling out bad behaviour. Move into work contexts where  positional authority fails to act, discloses confidential discussions and complaints or fails to act on reports of poor behaviour or unethical behaviour….to out and out punishment such as being overlooked for a promotion for raising issues with management or actually being blatantly told to “stand down or who do you think you are questioning me”. 

For organisations wishing to perform well (both in terms of results and wellbeing) is has been found that psychological safety is a lead indicator of performance, risk and wellbeing. 

However, research conducted by People Plus Science across boards, executive leadership teams, frontline teams and project teams found that “safety to report” is a critical component of “safety to contribute” and “safety to learn” and it is frustratingly low.  Only 71% of those interviewed said that they felt safe to report “the bare truth or reality” to executive leadership teams and boards. In fact just as many said that at one time or another they have had their reports “sanitised” or edited or been asked to “sanitise or edit” their reports.

“Safety is everyone’s responsibility.

 Everyone needs to know that they are empowered to speak up if there is an issue”. Captain Scott Kelly 

“Safety is a basic human need. People with a who feel valued, respected and safe, are motivated to care, learn and innovate. To change behaviours we are often looking at the wrong data. ” 

Advocates for speaking up

While there is evidence showing the importance of open communication in improving patient and consumer safety, communication failure among healthcare professionals remains one of the main causes of adverse events. Thus, in recent years, growing attention has been given to the “voice” of healthcare professionals with regard to “safety to report” to advocate for patient/consumer quality care. 

Voice refers to employees’ communication of information, ideas, suggestions, or concerns around work-related issues with the intent of bringing improvement in the working of their organisations. It is not just the health and community services industry it is across the board – financial services, education, IT, airlines and even with teams such as boards, oversight committees and executive leadership teams.

Healthcare professionals often come across situations that call for them to voice consumer safety threats such as violations of infection control standards, incompetent staff or processes, deficient handoffs, failure to disclose errors, and disrespectful behaviours that impede communication.

However, People Plus Science research has shown that, despite the potential for patient/consumer harm, employees hesitate to voice their concerns or suggestions due to various reasons such as hierarchical standing, fear of retaliation, and fear of damaging professional relationships. In addition, with burnout on the rise, the lack of “voice” is often reflective of the poor organisational supports for staff and a feeling of “what’s the point, nothing gets done anyway”.

 

Five reasons why employees fail to “report or speak up”:

1. Voicing concerns is “risky” – many times raising concerns or issues may have been received negatively by managers and colleagues. As a result employees hesitate to raise issues again.

2. A sense of powerlessness where they don’t feel like they are being listened to and recommendations won’t be acted upon.

3. Cultural norms (hidden or unhidden) which make it clear what is expected and consequences of speaking up.

4. Fear of looking incompetent in front of others when trust has not been established. 

5. Access- often access is an issue in an over burdened supervisor or leader. Whilst having an “open door” policy is great, if your team is under the impression that you are swamped and overburdened they are less likely to ask for help for fear of putting more pressure on you.

 

Ways to build "safety to report"

1. Build individual’s self confidence

2. Share knowledge and learnings as a group

3. Promote a culture of “safety to report and speak up”

4. Encourage staff at every opportunity to speak up, to challenge and share.

5. Link “speaking up” to a greater outcome ie patient care and support ( a positive motivator.

6. Remove  “blame” culture 

7. Build advocates throughout the business with key influencers.

8. Regularly evaluate the processes and procedures – do they support the culture you need.

9. Train your leaders on how to foster a positive work environment

10. Drive accountability and responsibility for reporting.

The ROI for "safety to report "

  1. Productivity Gains: Studies conducted by Safe Work Australia reveal that businesses promoting psychological safety experience a 22% increase in productivity. Employees who are disengaged are 53% more likely to take sick days. Employees who feel secure in their work environment are more engaged, creative, and collaborative, contributing to enhanced overall performance.

  2. Absenteeism Reduction: According to the Australian Bureau of Statistics (ABS), the economic impact of absenteeism due to mental health issues costs the Australian economy approximately $4.7 billion annually. By prioritising psychosocial hazard management, businesses can significantly reduce absenteeism, thereby safeguarding productivity and bottom-line results.

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3. Talent Retention: The turnover costs associated with employee churn due to burnout and dissatisfaction are substantial. A study by Beyond Blue indicates that companies focusing on mental health and psychological safety experience a 12% higher employee retention rate, saving considerable recruitment and training expenses. Conversely, disengaged employees are 3xmore likely to leave an organisation resulting in an increase in recruitment, onboarding and training costs. 

4. Innovation and Creativity: A mentally healthy workplace fosters innovation. The University of New South Wales found that organisations promoting psychological safety witness a 47% increase in employees’ innovative ideas. This is crucial in staying competitive and adapting to the ever-evolving business landscape.

5. Legal and Reputation Risk Mitigation: Workplaces that neglect psychosocial hazards may face legal repercussions and damage to their reputation. The Fair Work Commission reports a rising number of workplace mental health-related disputes. Proactive management not only safeguards against legal issues but also enhances the company’s standing in the eyes of clients, investors, and potential employees. An example of one health organisation identified that one leader was the root cause of over 100 complaints which cost the organisation over $206million in litigation costs.

6. Customer retention and advocacy: 25% of staff say that they take out their frustrations on consumers. People Plus Science researched the correlation between psychological safety of staff and likelihood to recommend and found a strong correlation ie those teams that are psychologically safe received higher recommendation scores from customers.

7. Costs of disengaged staff: Disengaged staff cost 34% of their annual salary  (per year that they are employed).

8. Reputational costs: With public scrutiny on the rise, the reputational costs of organisations being “named and shamed” are huge. From organisations who seek investors, to those who have government grants and contracts. The costs of reputational damage are difficult to calculate.

What do you need to do as an employer?

 To prevent work-related mental health injuries, employers should:
 
  • Promote a positive workplace culture that encourages trust, respectful behaviours, quality communication and psychological safety.
  • Consult with employees, customers, suppliers, contractors when identifying and assessing any risks to their psychological health and determining the appropriate control measures.
  • Implement policies and procedures for reporting and responding to psychosocial hazards such as workplace trauma, bullying, interpersonal conflict, violence and aggression; and reviewing and updating risk controls following any incidents.
  • Regularly ask employees how they are, encourage them to discuss any work-related concerns and, where required, implement suitable support and controls.
  • Have systems in place for workforce planning and workload management to ensure that employees have sufficient resources and a realistic workload.
  • Develop skills for leaders through coaching, mentoring and training to improve the support of employees.
  • Seek and act on feedback from employees during any organisational change process.
  • Inform workers about their entitlements if they become unwell or unfit for work.
  • Provide appropriate and confidential channels to support workplace mental health and wellbeing, such as Employee Assistance Programs.
  •  Evaluate the success of programs implemented to see if they have any impact.

What do we do as a board, oversight committee?

If you are a board, an oversight committee, an advisory board then you have a large responsibility. 

1. Accept accountability – how many boards have done a psychosocial hazard assessment. How many have viewed that of their organisation. How many can identify high risk teams? Or identify the high risk, high frequency hazards? How many can say that their employees (at all levels) feel safe to report bad news?

2. Understand the legal and regulatory frameworks.

3. Get independent reviews of the psychological safety and psychosocial hazards within the organisation.

4. Look at ensuring that you are looking “lead” indicators within your organisation and not lagging indicators.

5. Focus on lead indicators not lag indicators. Culture is not a lead indicator – it is a lag indicator. Engagement is not a lead indicator it is a lag indicator.

6. Assess the psychosocial risks of your customers and your employees. What psychosocial risks are your customers exposed to as a result of your employee’s behaviour? Your inadequate processes and systems? Your lack of training.

7. Train staff. What “essential” skills training have your leadership team being exposed to in the last 12months? What essential skills have you identified as being critical.

8. Ensure your policies and procedures work in practice. Combine other organisational knowledge. For example – having the right policies and procedures will not help you if your team leaders and organisations have low levels of trust. It is a tick box exercise with no foundations. Have you tried and tested the processes and policies you say will “stand up”?

The good news is that if you can get the “people stuff” right, your reliance on governance, risk management and policies and procedures will reduce. 

If as a board you think that cyber security, environment, financial risk, fraud, physical safety or innovation is the biggest concern – think again – all of these risks are driven by people. Performance is reliant on your people. Start there.

“Safety to contribute and improve is a basic human need. We engage in a process by expressing vulnerability and trust. How we are responded to sets the tone for the culture and is the largest contributor to safety to contribute. We are often looking at the wrong data to make significant and long lasting change.  Carolyn Grant

Interested in Learning More?

Book a briefing on psychological safety today. Mitigate your greatest risk and drive high performing, thriving teams.