Exploring the importance of team psychological safety in the development of two interprofessional teams

Abstract

It has been previously demonstrated that interactions within interprofessional teams are characterised by effective communication, shared decision-making and knowledge sharing. This paper outlines aspects of an action research study examining the emergence of these characteristics within change management teams made up of nurses, general practitioners, physiotherapists, care assistants, a health and safety officer and a client at two residential care facilities for older people in Ireland. The theoretical concept of Team Psychological Safety (TPS) is utilised in presenting these characteristics. TPS has been defined as an atmosphere within a team where individuals feel comfortable engaging in discussion and reflection without fear of censure. Study results suggest that TPS was an important catalyst in enhancing understanding and power sharing across professional boundaries and thus in the development of interprofessional teamwork. There were differences between the teams. In one facility, the team developed many characteristics of interprofessional teamwork while at the other there was only a limited shift. Stability in team membership and organisational norms relating to shared decision making emerged as particularly important in accounting for differences in the development of TPS and interprofessional teamwork.2

A systematic review exploring the content and outcomes of interventions to improve psychological safety, speaking up and voice behaviour

“…O'Leary [48] conducted action research meetings with two newly-formed interprofessional project teams. The supportive leadership style used by the author encouraged psychological safety within team meetings.…”

“…One further study [36] found no significant relationship. Three studies [39,46,47] reported improved and one study [48] found mixed results for "communication and collaboration" following interventions. Five studies [38,40,42,44,45] reported positive evaluations by participants postinterventions.…”

“…Five studies [38,40,42,44,45] reported positive evaluations by participants postinterventions. Three studies had "Psychological safety" as an outcome, with one of these reporting mixed results for the impact of the intervention on psychological safety [48] and the other two reporting improvement [37,47]. Mixed results were found for the impact of one intervention on "power sharing" [48].…”

“…Three studies had "Psychological safety" as an outcome, with one of these reporting mixed results for the impact of the intervention on psychological safety [48] and the other two reporting improvement [37,47]. Mixed results were found for the impact of one intervention on "power sharing" [48]. Lastly, one study [46] showed a positive impact of the intervention on creating an "open climate" and another showed improvement in "trusting relationships" [47].…”

Turning to case studies as a mechanism for learning in action learning

“…Establishing causal links in an inter-organisational context is even more complex than establishing them at individual and organisational level as it can be difficult to attribute outcomes to involvement in a network and to distinguish them from outcomes that may have occurred anyway (Provan and Sydow 2008). Complexity is also increased by the existence of various factors that can influence interactions between individuals from different backgrounds such as trust and power (O'Leary 2016). This can impact on network processes and outcomes and may also affect decisions on who should be involved in evaluation.…”