Leadership; Quality improvement; Safety culture; Simulation; Team training; Humans; Vietnam; Patient Care Team/standards; Psychological Safety; Patient Safety/standards; Health Personnel/psychology; Health Personnel/education; Health Personnel; Patient Care Team; Patient Safety; Leadership and Management; Health Policy; Public Health, Environmental and Occupational Health
Abstract :
[en] Psychological safety is a crucial component in highly functioning healthcare teams, enabling every member to speak up, take innovative risks and admit mistakes without fear of personal attack or repercussions. Leaders play a significant role in fostering this positive environment that boosts effective communication, enhances teamwork and decision-making and promotes incident reporting. Developing these non-technical skills, along with updated medical knowledge and procedural skills, is a key factor in providing better and safer patient care.Creating and sustaining psychological safety in the workplace requires a cultural and mindset shift that impacts how team members interact with each other. The anaesthesia teams from seven VinMec Healthcare System (VMHS) hospitals across Vietnam faced several critical challenges, including cultural embeddedness, geographical dispersion and a hierarchical structure where deference prevailed.Nonetheless, VMHS leadership established a goal to transform the Anaesthesia and Pain Management Department into one of the safest in Southeast Asia. A multifaceted team comprised of top management, training experts and simulation specialists was essential in driving the initiative forward.The intervention highlights the importance of leadership engagement, structured curriculum design and feedback loops to ensure continuous improvement in staff competency and collaboration. Over 18 months, 112 anaesthesia doctors and nurses completed a series of online learning modules and on-site simulation training sessions. Preliminary outcomes indicate significant progress in non-technical skills such as communication, teamwork and cognitive aid utilisation among participants. There has also been a noticeable reduction in patient safety incident scores across hospitals.This article presents a replicable model for addressing the cultural, practical and logistical challenges of integrating psychological safety into a large healthcare system by introducing an innovative, mixed-method training programme. It provides insights for healthcare leaders seeking to achieve sustainable improvements in patient safety and quality of care.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Vu, Viet ✱; Anesthesiology and Pain Department, Vinmec Healthcare System, Hanoi, Viet Nam
Buleon, Clément ✱; Université de Liège - ULiège > Département des sciences de la santé publique > Médecine d'urgence ; Center for Medical Simulation, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Le, Thuy Anh; CEO Office, Vinmec Healthcare System, Hanoi, Viet Nam
Lua, Clara Christina Paula; Anesthesiology and Pain Department, Vinmec Healthcare System, Hanoi, Viet Nam
Martin, Frédéric; Private Hospitals of Versailles - Ramsay Santé, Versailles, France
Minehart, Rebecca; Center for Medical Simulation, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA ; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
Macaire, Philippe ; Anesthesiology and Pain Department, Vinmec Healthcare System, Hanoi, Viet Nam ph.macaire@gmail.com clement.buleon@wanadoo.fr
✱ These authors have contributed equally to this work.
Language :
English
Title :
Changing minds, saving lives: how training psychological safety transforms healthcare.
Alternative titles :
[fr] Changer les mentalités, sauver des vies : comment la formation à la sécurité psychologique transforme les soins en santé.
Ravi D, Tawfik DS, Sexton JB, et al. Changing safety culture. J Perinatol 2021;41:2552-60.
Jung OS, Kundu P, Edmondson AC, et al. Resilience vs. Vulnerability: Psychological Safety and Reporting of Near Misses with Varying Proximity to Harm in Radiation Oncology. The Joint Commission Journal on Quality and Patient Safety 2021;47:15-22.
Kumar S. Psychological Safety: What It Is, Why Teams Need It, and How to Make It Flourish. Chest 2024;165:942-9.
Picard J, Evain J-N, Douron C, et al. Impact of a large interprofessional simulation-based training course on communication, teamwork, and safety culture in the operating theatre: A mixed-methods interventional study. Anaesth Crit Care Pain Med 2022;41:100991.
Diaz-Navarro C, Armstrong R, Charnetski M, et al. Global consensus statement on simulation-based practice in healthcare. Adv Simul 2024;9:19.
Hippe DS, Umoren RA, McGee A, et al. A targeted systematic review of cost analyses for implementation of simulation-based education in healthcare. SAGE Open Med 2020;8.
Ogrinc G, Davies L, Goodman D, et al. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. BMJ Qual Saf 2016;25:986-92.
Tear MJ, Reader TW, Shorrock S, et al. Safety culture and power: Interactions between perceptions of safety culture, organisational hierarchy, and national culture. Saf Sci 2020;121:550-61.
Singer SJ, Falwell A, Gaba DM, et al. Identifying organizational cultures that promote patient safety. Health Care Manage Rev 2009;34:300-11.
Nembhard IM, Edmondson AC. Making it safe: the effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams. J Organ Behavior 2006;27:941-66.
Kirkpatrick JD, Kirkpatrick WK. Kirkpatrick's Four Levels of Training Evaluation. Alexandria, VA: atd Press, 2016.
Sorra J, Famolaro T, Hare R, et al. AHRQ hospital survey on patient safety culture version 2.0: user's guide. 2019. Available: https://www. ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/2021- HSOPS2-Database-Report-Part-I-508.pdf
Famolaro T, et al. Surveys on patient safety culture (sops) hospital survey 2.0: 2021 user database report. 2021. Available: https://www. ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/2021- HSOPS2-Database-Report-Part-I-508.pdf