Occupational Health: How Employee Psychology and Performance Quality Impact Patient Care

 

- Bijaya Dhakal, MSc, MPH, RPhT

Introduction

The psychology of employees in the healthcare setting is one of the major factors that contribute to the quality of healthcare services. Creating a psychologically safe environment at the workplace is everyone's responsibility, including the management team. According to Harvard Business Review Press (2022), psychological safety is a shared belief held by members of a team that it's OK to take risks, express their ideas and concerns, speak up with questions, and to admit mistakes — all without fear of negative consequences. A psychological safety environment is important in any setting, whether workplace, home, or school. The main aim of this article is to make the public aware of how the psychological safety environment impacts the quality of patient care in healthcare settings, how such an environment can be created, maintained, and improved to enhance team performance and quality care.

Generation Gap At Workplace

Today, leadership styles are evolving. In the past, managers and directors had to behave like big people and sound like a boss. Their opinion was believed to be the best. Managers used to constantly monitor employees, overseeing every task to ensure everything was done correctly, often acting like taskmasters. This behavior stemmed from a belief that the boss knew everything and lacked trust in their employees. These days, managers are learning new leadership styles of macro management instead of micro-managing. There are a lot of long-term serving staff who have developed their confidence and leadership through long-term practices at the workplace without updating their management knowledge through new skills, mindset, and updated learning courses, as well as academic programs on management. Many academic and technical programs do not include management and leadership modules in the curriculum. As a result, there are some workplaces where long-term staff run the department without updated knowledge. Their belief that what is right for them is always right, and they do not listen to the new hires who may have new ideas, opinions, and education. Such a difference between older generation employees and new or younger employees creates generation gaps, misunderstandings, disrespect for new ideas and opinions. These gaps, cracks, and holes contribute to poor communications, misunderstandings, closed minds, feelings of disrespect, and a psychologically unsafe environment at the workplace. If the healthcare setting/environment is not psychologically safe for team members to work and spend every day, the patients and clients cannot receive the quality of care the organization aims for. The organization has the best policy in place, but if the closed-minded staff can not create a psychological safety environment, the organization can not provide quality care, which impacts the organization's reputation. To protect an organization's reputation and service quality, the higher-level management team must understand what is happening among the frontline team during daily workplace practices.

What To Look For?

Lately, management is slowly turning to an open system, encouraging ideas and opinions from team members, encouraging open discussions, and participation. Still, in some cases, even though the policy is in place and is being put into practice, there is a necessity of changing staff's beliefs and behaviors rooted in their unconscious and subconscious mind, old ways of working, leading, and delivering. Thus, the practical aspect of system change is still to be improved, and its time-consuming nature is a concern.  It may differ in a case-by-case scenario or may not apply in many situations. The healthcare setting is a very busy environment, where we perform tasks with common goals to meet the requirements of organizations' patient-centered care principles. Teamwork, an open and psychologically safe environment, is a must for better delivery of care.

Team members' emotional intelligence level is another factor that contributes to a psychologically safe environment. According to Travis Bradberry & Jean Greaves (2009), Emotional Intelligence is your ability to recognize and understand emotions in yourself and others, and your ability to use this awareness to manage your behavior and relationships. Emotional Intelligence level among members of the team and a psychologically safe workplace environment are connected and have been a popular topic these days.

Center for Creative Leadership implies that, "Psychological safety in the workplace doesn't mean constant harmony—it means people feel comfortable brainstorming out loud, expressing incomplete ideas, challenging the status quo, giving and receiving feedback, and navigating disagreements together." In the healthcare settings, staff such as nurses, doctors, pharmacists, pharmacy technicians, psychologists, counsellors, assistants, support staff, information technologists, and other administrative staff, all work in a collaborative team to provide quality care, where emotional intelligence among staff and a psychological safety environment are crucial contributing factors in creating a quality environment. In this century of artificial intelligence, emotional intelligence can not be ignored.

How To Create a Psychological Safe Environment ?

High-performing teams are nurtured or created with specific strategies; it does not happen by itself. To create such an environment, the staff have to feel fulfilled, feel free to express, without fear, embarrassment, or guilt for any actions. The feeling of safety maintains the attitude of high performance, doing more, staying motivated, and appreciating others. Employees in a psychologically safe environment have better decision-making, higher ability to voice their opinion and perspectives, and develop a continuous learning and improvement attitude, while trusting each other in the team.

Here are a few tips for creating a psychologically safe environment

  • Resolve conflicts in the workplace
  • Practice self-reflection and think from others' points of view
  • Stay calm, listen to others first, delay responding right away, but acknowledge others' opinions.
  • Identify solutions to problems and conflicts.
  • Develop and implement an action plan.
  • Celebrate small wins
  • Review and evaluate the impacts.

 How Does a Psychologically Safe Environment and Emotional Intelligence Impact Quality Patient Care?

There is a strong connection between a psychologically safe environment, a high level of emotional intelligence, and effective communication, which impacts mindful actions and develops a mindful professional practice. Unsafe environment in the workplace negatively affects the emotional and psychological well-being of team members, often leading to behaviors such as blaming, irritation, frustration, emotional outbursts, dissatisfaction with job responsibilities, and a lack of motivation to come to work. Professional practice cannot be carried out effectively with poor emotional and psychological health, as it disrupts a team member's mental focus. This psychological strain can lead to patient care services such as medication administration errors, errors during surgical procedures, nursing care, and diagnostic testing, ultimately hindering the ability of the employee to perform tasks mindfully and accurately. Appropriate and respectful communication is an important factor in reducing healthcare service mishaps. If negativity exists in the workplace, team members may feel demotivated to join the team the next day, and it may contribute to more sick calls. We cannot deny the fact that most of us want appreciation from others, which is one way to stay motivated at work. That is the reason why we need to have a positive and safe workplace environment to deliver quality patient care. 

Conclusion

Psychologically safe healthcare settings and a high level of emotional intelligence among healthcare professionals contribute to a high-performing team, where patients stay safe and receive quality care. Psychological safety does not mean that everyone is nice at all times during duties, but it means everyone can flourish their positive psychology, feel valued, welcomed, respected, and take their perspectives positively, where they can stay motivated, and perform high-quality care to their patients.

References

Center For Creative Leadership. (2024, April 10). How Leaders Can Build Psychological Safety at Work. Retrieved from Center For Creative Leadership: https://www.ccl.org/articles/leading-effectively-articles/what-is-psychological-safety-at-work/

Gallo, A. (2023, Feb 15). What is Psychological Safety? Retrieved from Harvard Business Review: https://assets.speakcdn.com/assets/2332/what_is_psychological_safety_.pdf

MHA. (2023). What is emotional intelligence and how does it apply to the workplace? 

Mental Health America: https://mhanational.org/what-emotional-intelligence-and-how-does-it-apply-workplace 

Bradberry, T., & Greaves, J. (2009). Emotional Intelligence 2.0 Talent Smart