[Psychological safety for health care staff: What? Why? How?]

Psychological safety refers to an individual's experience of the work environment as conducive to interpersonal risk-taking without risk for reprisals. Fear of reprisals has been well documented in health care, including in Sweden. In the literature and our teaching, we have consistently found that when psychological safety is low, it can lead providers to violate the basic tenet "first, do no harm".  Psychological safety resides at the team level. It is established and maintained by the leader. Several contributing leadership qualities and behaviors have been identified. Leaders can train how to support psychological safety by how they choose to set the stage, invite participation, and respond productively when they interact with their staff. Leaders may experience this as challenging and anxiety-provoking. However, leaders need to actively improve psychological safety in care teams to support learning, improvement, and co-creation in health and care.