Human factors remain a key contributor to patient harm. However, healthcare organizations struggle to learn from mistakes, hindering the reduction of medical errors. Psychological safety (PS)...Show moreHuman factors remain a key contributor to patient harm. However, healthcare organizations struggle to learn from mistakes, hindering the reduction of medical errors. Psychological safety (PS) enhances team functioning and reduce medical errors by stimulating open communication and giving and receiving feedback while a punitive working culture can lower PS, leading to decreased team performance and increased patient harm. Similar to a punitive working culture, when group norms (GN) are present, non-normative behavior can lead to rejection, causing physical and emotional distress that could undermine PS. This study therefore explores the impact of GN on PS. This study examined the impact of GN on PS using qualitative and quantitative methods. Different outcomes were observed when analyzing the impact of GN on PS, depending on whether a homogeneous or heterogeneous dataset was used. The homogeneous dataset showed no relationship between PS and GN, while the heterogeneous dataset indicated a significant positive correlation. The study had some limitations, including a small sample size and the use of self-constructed surveys to assess GN. Despite the non-significant results in the homogeneous dataset, the role of GN in evaluating PS should not be disregarded. Future research should focus on exploring the influence of GN on PS and address methodological challenges associated with studying implicit behavioral rules. In conclusion, understanding the impact of GN on PS is crucial for improving patient safety in healthcare settings. By addressing the limitations of this study and conducting further research, healthcare organizations can develop interventions to enhance PS, reduce medical errors, and create a culture of safety.Show less
E-commerce is constantly changing since the innovation of mobile devices. In this study, purchase behavior will be analyzed more in-depth between desktop and smartphone. Having a better...Show moreE-commerce is constantly changing since the innovation of mobile devices. In this study, purchase behavior will be analyzed more in-depth between desktop and smartphone. Having a better understanding of the human-computer interaction is an interest within MetrixLab for the innovation of their DFST research. Aiming to answer the following research question: !Do we see differences in e-commerce data when a study has been completed on desktop or smartphone?” E-commerce data is made up of the following variables: time in store, stopping power, and purchase preference. We expected a difference in time in store and stopping power (click-through rate), with participants shopping on desktop having a lower quantity compared to participants in the smartphone condition. We expect no difference between purchase preference of the two devices. A total of 251 participants were included in this study, 164 placed in the desktop condition and 87 in the mobile condition. This study was divided in three sections: (1) pre-questionnaire, (2) an online shopping assignment, and (3) a post-questionnaire. It was found that using desktop, participants spent significantly longer in store (p < .05) and stopping power (p < .01) was higher compared to using a smartphone. Purchase preference (p <.05) showed a significant difference between the two devices. There is a significant difference between devices which should be researched further to draw conclusions. Limitations of this study was the chosen population and analyzed variables. Future study could include a broader range of participants and products, featuring a wider range of variables, including eye-tracking movement.Show less
One of the current challenges to increase patient safety is to improve the patient safety culture (Verbakel et al., 2014). An important factor in a good patient safety culture is psychological...Show moreOne of the current challenges to increase patient safety is to improve the patient safety culture (Verbakel et al., 2014). An important factor in a good patient safety culture is psychological safety (Edmondson & Lei, 2014). It is important that personnel feels free to speal up about mistakes or possible improvement to enhance patient safety. However, speaking up about mistakes may harm the perception towards your competence as an individual. Therefore, the perception of others is important when speaking up about mistakes, and may harm the psychological safety someone experiences. To increase the psychological safety it is therefore important to understand the influence of the perception of others on psychological safety. In this study two goals are formulated: 1) map the perception of others in the three departments in Hospital A. 2) Investigate the relation between the perception of others and psychological safety. The second goal is investigated with use of the following hypotheses: 1) Physician Assistants have a high perceived competence score, compared to Nurses, 2) Nurses have a high warmth score and low competence score, compared to Physician Assistants, 3) Specialists gave a high competence score, as perceived by Physician Assistants and Nurses, 4) The psychological safety level is lower in Nurses, compared to Physician Assistants. To answer these hypotheses mixed-methods design is used, gathering data from online questionnaires (N = 39), which were the SCM questionnaire (Fiske et al., 2002) and the Psychological safety questionnaire (Garvin et al., 2008), observations of quality meetings (N = 13) and semi-structured interviews (N = 3). The questionnaires were first tested on a M-Turk sample of healthcare personnel, to identify the internal consistency of the questionnaires in a healthcare setting. Results showed a significant difference in perception of the competence score of Physician Assistants, with Nurses perceiving the competence level lower than the Physician Assistants. Moreover, the perceived warmth score of Nurses were found to be significantly higher within Physician Assistants, compared to Nurses. This result was not found in the perceived competence score of the Nurses. Furthermore, the perceived competence score of Specialists was found to be non-significant when comparing the perception of Nurses and Physician Assistants. At last, the psychological safety level of Nurses and Physician Assistants did not differ significantly. These results indicate that the experienced hierarchy in Hospital A is less present than originally thought. Furthermore, no correlation was found between the perception of others and psychological safety within Hospital A. However, due to the small sample size we must be cautious with drawing conclusion of the results and more research is needed to gain more insight in the current situation at Hospital A.Show less
In scientific literature, noise and noise annoyance are almost inseparable. While different environmental noise sources can cause various responses, the most common reaction to noise is irritation....Show moreIn scientific literature, noise and noise annoyance are almost inseparable. While different environmental noise sources can cause various responses, the most common reaction to noise is irritation. Several studies have focused on one aspect of noise annoyance, such as attitudes or health. However, a comprehensive picture of factors contributing to noise annoyance is not drafted yet, so this study aims to fill that gap. The study was conducted remotely for ten consecutive days in the daily life of 32 participants. It consisted of two main tasks: (1) wearing an activity tracker and (2) submitting flyover events into the NLR study app. We hypothesised that healthy coping mechanisms would predict lower reported noise annoyance and that predictors of higher reported noise annoyance are more negative attitudes, prevalent unhealthy coping habits, perceived louder and higher-pitched flyovers, and perceived lengthier flyover events. The main questionnaires analysed in this study to test the hypotheses were the ICBEN 11-point scale, BriefCOPE and the attitude component from the NORAH study. Attitudes and coping mechanisms are not verified as predictors in this study. The results do imply that subjective volume, subjective pitch, and subjective duration of a flyover event are good predictors of reported noise annoyance. Further research is needed to explore how subjective volume, pitch, and exposure duration as intervention targets can help reduce aircraft noise disruptions in individuals that live in affected areas.Show less
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
A hospital in the Netherlands is currently investigating where they are standing in terms of a safe learning environment. This is investigated to eventually implement Safety-II within their work-...Show moreA hospital in the Netherlands is currently investigating where they are standing in terms of a safe learning environment. This is investigated to eventually implement Safety-II within their work- and learn processes. The safety management approach of Safety-II emphasizes how safety is achieved in daily work. Since speaking up is an important factor for learning and improvement, this study aimed to examine the status of psychological safety among healthcare workers at the Dutch hospital. To address current problems surrounding staff shortage in healthcare, we additionally aimed to investigate how healthcare workers could be retained to their hospital work environment. This pilot study researched the relationship between perceived organizational support (POS), psychological safety, and affective organizational commitment (AOC). Drawing on previous theories, we hypothesized and examined a mediator model predicting AOC. A mixed-method design was used for an in-depth understanding of POS, AOC, and psychological safety among healthcare professionals (N = 38) of a Dutch hospital. The data was collected through a survey, online observations during team meetings, and three interviews. This study provides new support to the importance of POS for organizational commitment. Results showed that POS increased psychological safety among healthcare professionals. Adding to the literature, it was found that in particular support from team leaders was important for higher levels of psychological safety. Our findings also indicate that POS has a positive impact on AOC, but this was not mediated by psychological safety. More research is required to better understand how POS exactly contributes to AOC. Based on our findings, we recommend including perceived support from team leaders within further research on psychological safety.Show less
This study examines the relationship between the self-determination theory and perceived psychological safety, respectively popularized by Edward Deci and Richard Ryan; and Amy Edmondson. Whereas...Show moreThis study examines the relationship between the self-determination theory and perceived psychological safety, respectively popularized by Edward Deci and Richard Ryan; and Amy Edmondson. Whereas psychological safety has been found to positively contribute to team performance, the self-determination theory is used to assess individual needs and fulfilments, and can be a contributor to individual performance. The aim of this potential relationship is to enable the use and combination of individual-, and team-based strategies more effectively in order to enhance overall performance in organizations. I hypothesized that a significant positive correlation exists between self-determination theory factors and perceived psychological safety, and that the former could be used to predict the latter. The data gathered in an international online survey among people working in the healthcare sector supports that there is a significant positive correlation between the levels of the self-determination theory’s autonomy component and perceived psychological safety. However, when setting up a regression model, I found that the autonomy component of self-determination theory is the only significant predictor for the level of perceived psychological safety. This model explains five percent of the variance in the level of perceived psychological safety, and is thus practically of no use. Secondly, hypothesized that there are no gender-based differences in levels of self-determination theory and perceived psychological safety. In the analysis I found that there are generally no gender- based differences in either of the variables, except for the competence component of self- determination theory. This potentially signifies that men and women prioritize their psychological needs differently, but more research is needed to confirm this. In conclusion, based on the evidence gathered in this study, I cannot conclude that the relationship between self-determination theory and psychological safety can be used in a meaningful way to increase overall performance in the healthcare sector, or other organizations for that matter.Show less
The present study investigated operating room (OR) traffic at the OR’s of two Dutch hospitals. OR traffic is one of the multiple causes of surgical site infections (SSIs). Hospitals are trying to...Show moreThe present study investigated operating room (OR) traffic at the OR’s of two Dutch hospitals. OR traffic is one of the multiple causes of surgical site infections (SSIs). Hospitals are trying to reduce their amount of OR traffic as much as possible in order to reduce the number of SSIs. Knowing how much variation of the amount of OR traffic occurs and knowing the reasons for its occurrence, is important to actually be able to reduce OR traffic to an tolerable level. For this study, OR traffic was investigated by observing OR traffic during surgeries (N = 83). On average, 4.29 door openings per hour occurred. Between the hospitals, the averages of OR traffic per hour differed greatly (hospital 1 M = 3.00, hospital 2 M = 5.23). Overall, there was a positive linear relation between the amount of OR traffic and the duration of a surgery. Two-way traffic was related to less overall OR traffic. Visible signs about the OR traffic policy did not seem effective in reducing OR traffic. Based on the results of this study, practical recommendations to improve OR traffic policy were proposed. Also, we advised on improving OR traffic registration and efficient behavior of OR personnel to reduce OR traffic.Show less
In hospitals, preventable incidents still occur and safety management may have reached its peak. Therefore, learning from these incidents is imperative to reduce preventable harm. A prerequisite...Show moreIn hospitals, preventable incidents still occur and safety management may have reached its peak. Therefore, learning from these incidents is imperative to reduce preventable harm. A prerequisite for learning is the willingness of staff to report. A safety management mode known as Safety-II may yield benefits in reporting behavior. Based on existing literature, reporting behavior may be influenced by personality. This study aimed to investigate if the proposed safety management mode will increase reporting behavior. Additionally, this study investigated if personality is a significant predictor in reporting behavior. To test this, participants consisting of two groups i.e., calamity investigators (with training in Safety-II) and random medical staff (without training) were compared. Data was gathered by distributing questionnaires among participants; one for personality and one for reporting behavior. The reporting questionnaire was distributed on a second occasion, to measure implications over time. It was expected that training in Safety-II leads to an increase in reporting behavior. Additionally, it was expected that personality influenced reporting behavior. Results showed a significant difference in one facet of reporting behavior (i.e., perceived blame) between groups with training in Safety-II and without training. Extraversion and neuroticism were found to be predictors for one facet of reporting behavior (i.e., perceived criteria for events that should be reported). Implications may be that the training main focus is to exempt blame from being a factor in reporting. Implications may also be that personality is not a great predictor of reporting behavior. Future lines of research may focus on increasing the number of participating hospitals, perhaps even broadening the study across different nations, to examine cultural differences.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
In times of rapid change, like what the world is currently going through, certain organizational circumstances might facilitate adapting to novel situations, especially in complex organizations...Show moreIn times of rapid change, like what the world is currently going through, certain organizational circumstances might facilitate adapting to novel situations, especially in complex organizations like health care. Health care workers having an innovative mindset might be one of these circumstances. Further, this mindset and health care workers’ innovative work behaviours (IWB) might be facilitated by the existence of psychological safety within their work teams. However, to understand the relationship between psychological safety and IWB and to be able to induce it, it is crucial to understand what dynamics underlie this relationship. In this study, the relationship between psychological safety and IWB, and whether this relationship was mediated by tacit and/or explicit knowledge sharing, were investigated. The sample consisted of 182 health care workers (120 females, 62 males, Mage = 36.25) and they were recruited through Amazon’s Mechanical Turk platform. Participants filled out an online questionnaire consisting of 36 questions about psychological safety, tacit and explicit knowledge sharing, and IWB within their work teams. Results indicated that while explicit knowledge sharing had an indirect effect on the relationship between psychological safety and innovative work behaviours, indicating mediation, tacit knowledge sharing did not have a significant indirect effect. The cognitive effort involved in sharing knowledge is discussed as a potential reason why a mediating effect was not observed for tacit knowledge sharing. Recommendations for further research and the limitations of the current study are discussed.Show less
Working in teams has become common in many organisations. In studies about the performance of teams, psychological safety has become an popular topic. Psychological safety describes an atmosphere...Show moreWorking in teams has become common in many organisations. In studies about the performance of teams, psychological safety has become an popular topic. Psychological safety describes an atmosphere were employees feel comfortable speaking up about their concerns and new ideas. As the performance of an organisation is often dependent on innovation and innovative behaviour, we propose that psychological safety can positively predict innovative behaviour. Additionally, diversity was studied, specifically the characteristics age, gender, and work experience, and their individual influences on innovative behaviour and psychological safety. Previous research has shown mixed results about the performance of diverse teams, therefore it is necessary to extent research in this field. Data was collected using an online survey with questions regarding innovative behaviour and perceived psychological safety by employees from a Dutch organisation (N = 375). First, we used a simple linear regression to map the relationship between innovative behaviour and psychological safety. Second, we performed a simple linear regression to find the individual influences of age, gender, and work experience on respectively innovative behaviour and psychological safety. Additional analyses were performed to extend insight into the relations and internal structures of these constructs. Results showed that psychological safety is a positive predictor of innovative behaviour and that work experience can predict innovative behaviour in certain circumstances. We conclude that psychological safety can predict innovative behaviour and that diverse characteristics are unlikely to influence both constructs separately. However, further research is necessary to explain the role of diversity in this relationship, as this study has not been able to measure diversity as a team characteristic. Further suggestions and limitations are discussed.Show less
