One in every ten hospitalized patients suffers from an unintended or undesirable outcome of treatment, often referred to as complications. Organizations in healthcare need to learn from these...Show moreOne in every ten hospitalized patients suffers from an unintended or undesirable outcome of treatment, often referred to as complications. Organizations in healthcare need to learn from these events to prevent recurrences and improve patient safety. However, the methods used to learn from these complications do not appear to have the desired effect, evident from the absence of a decrease in complications. To improve learning processes, it is necessary to know which steps hamper the learning process, thereby hindering optimal learning. For this pilot study the theoretical framework ‘Learning from Incidents Process’ (LFIP) (Drupsteen et al., 2013) is introduced in the healthcare domain. Originally the framework was developed for the (non-healthcare) industry to identify bottlenecks that inhibit learning processes and to get an indication of the use of learning potential throughout the process. The model is renamed as ‘Learning from Complications Process’ (LFCP) to fit the healthcare context. With this study the LFCP-model is introduced and applied in a hospital setting, aiming to answer the following research questions (1) Are the steps in the LFCP formally arranged and executed at Hospital X and how well do they work according to the medical staff? (2) At what steps in the LFCP does the medical staff experience bottlenecks, that hamper the learning process and its outcomes? (3) To what extent does psychological safety influence this learning process? The internal consistency of the LFCP-questionnaire was tested on an M-Turk sample of healthcare employees, to justify use within a healthcare setting. To answer the hypotheses, a mixed-methods design is applied. The data for this study were gathered by use of online questionnaires (N = 6), semi-structured interviews (N = 3) and online observations (N = 13). It is expected to find results indicating sub-optimal use of learning potential, and a diversity of bottlenecks throughout the LFCP. Results showed a significant decline in formally arranged, executed and quality of executed steps throughout the LFCP. Consequently, the use of learning potential followed this line of decline, with the biggest loss of learning potential at the evaluation stage. Bottlenecks were identified after stage 1 ‘Understanding causation’. However, no correlation was found between psychological safety and the LFCP. These results indicate that there is ample room to improve the quality of the learning processes, implying that patient safety can be further enhanced by improving the quality of total learning processes. For the future the LFCP-model can be used as a tool to quantify results of interventions to improve the quality of learning processes. Because of the small sample size this pilot study is a proof of concept. Therefore, no hard inferences can be drawn, and results should be treated with the utmost caution.Show less
When it comes to teamwork, it is vital to communicate well with one another, especially when the lives of patients are in your team’s hands. In order to communicate well, hospital workers must feel...Show moreWhen it comes to teamwork, it is vital to communicate well with one another, especially when the lives of patients are in your team’s hands. In order to communicate well, hospital workers must feel psychologically safe enough within their team to address questions, problems, and errors, and must feel free to make suggestions and give feedback. This study investigates, by the means of a survey on psychological safety and network ties, whether social network ties within and between teams can predict the psychological safety of hospital workers, as they work with colleagues outside of their team as well. Asking for advice from (different) team members and being friends with team members was hypothesised to indicate that the team psychological safety is adequate. Having difficulties with team members was expected to lower the perception of psychological safety. Over the course of three weeks, 70 hospital workers answered the survey via Mechanical Turk and the results from the linear regressions suggest that advice ties positively affect and difficulty ties negatively affect team psychological safety, but only when psychological safety scores were at the lower end of the scale. Team tenure did not moderate the effect that network ties have on psychological safety while larger team sizes may weaken this effect. Future tools for improving psychological safety in hospital teams can make use of the knowledge that advice ties and difficulty ties are possible ingredients of a low psychological safety team moving to a desired level of psychological safety.Show less
In the dynamic world of healthcare, where people work together in multidisciplinary teams, psychological safety is necessary for effective teamwork. Psychological safety leads to more team learning...Show moreIn the dynamic world of healthcare, where people work together in multidisciplinary teams, psychological safety is necessary for effective teamwork. Psychological safety leads to more team learning, self-expression and personal engagement that in turn increases team effectivity. With those beneficial effects in mind, an important part (the first subquestion) of this study focused on the level of psychological safety of various actors at the department of Neurology/Neurosurgery/Neurocare in a large university hospital. Furthermore, this first subquestion served a larger goal. The hospital is about to implement changes in rules and regulations concerning the work activities of healthcare workers, in order to increase patient safety. According to the results of this study, the level of psychological safety was on an adequate level. The second subquestion addressed the prevalent communication styles among colleagues on the work floor of the abovementioned departments. The results suggested that healthcare workers use significantly more directive (dominant and contentious) communication styles compared to non-directive (attentive and friendly) communication styles. No difference was found between the communication styles of nurses and doctors. Since the way of communication may influence psychological safety, the third subquestion focused on the relationship of communication styles and psychological safety. No association was found between those two concepts. However, we found some indications in our very small sample size that nurses with non-directive communication styles may be vulnerable to experiencing a lower level of psychological safety. Because of Covid-19 regulations, the sample size was limited, so the findings are not generalisable. However, this study does serve as a proof-of-concept of a study that can be conducted in the future. In a subsequent similar study, the same method with some modifications can be used to get more generalisable findings and insights into the relationship between communication styles and psychological safety.Show less
