Psychological safety and emergency department team performance: A mixed-methods study

Area of Science:

• Healthcare Management
• Team Dynamics
• Occupational Psychology

Background:

• Team culture is integral to high-performing teams.
• Psychological safety, a key component of team culture, enables interpersonal risk-taking.
• Psychological safety in emergency departments (ED) remains underexplored.

Purpose of the Study:

• To explore psychological safety within an Australian tertiary care ED.
• To identify factors influencing psychological safety in ED teams.

Main Methods:

• A sequential mixed-methods study involving nursing and medical staff.
• Quantitative data collected via surveys (Team Learning and Psychological Safety Survey, narrative questionnaire).
• Qualitative data gathered through semi-structured interviews, analyzed using deductive thematic analysis.

Main Results:

• A median psychological safety score of 37/49 was observed.
• Psychological safety was not uniformly experienced, with lower levels reported by nurses and new staff.
• Familiarity with colleagues and leaders emerged as the primary factor influencing psychological safety.

Conclusions:

• Familiarity among team members and leaders is critical for developing psychological safety in EDs.
• Frontline leadership should prioritize fostering familiarity during shifts.
• Enhancing psychological safety requires departmental focus on building team familiarity.