Everyone matters; everyone contributes; everyone grows: a pilot project cultivating psychological safety to promote growth-oriented service culture after the Oakden Report
Duncan McKellar A E F , Diana Renner B C , Amelia Gower D , Sinead O’Brien B E , Andrew Stevens B and Antonietta DiNiro AA Older Persons’ Mental Health Service, Northern Adelaide Local Health Network, 116 Reservoir Road, Modbury, SA 5092, Australia. Email: antonietta.diniro@sa.gov.au
B Uncharted Leadership Institute, 167 Flinders Street, Adelaide, SA 5000, Australia. Email: diana.renner@unchartedleadership.com.au; sinead.obrien@unchartedleadership.com.au; andrew.stevens@unchartedleadership.com.au
C Australian Adaptive Leadership Institute, Care of People Measures, Level 10, 210 Clarence Street, Sydney, NSW 2000, Australia.
D Nursing and Midwifery Office, Department for Health and Wellbeing, CitiCentre Building, 11 Hindmarsh Square, Adelaide, SA 5000, Australia. Email: amelia.gower@sa.gov.au
E Lyell McEwin Health Service, Northern Local Health Network, Haydown Road, Elizabeth Vale, SA 5112, Australia.
F Corresponding author. Email: duncan.mckellar@sa.gov.au
Australian Health Review 44(6) 867-872 https://doi.org/10.1071/AH20156
Submitted: 25 June 2020 Accepted: 13 September 2020 Published: 30 November 2020
Journal Compilation © AHHA 2020 Open Access CC BY-NC-ND
Abstract
The development of positive workplace culture is important for health services, with implications for patient experience, staff wellbeing and service outcomes. The Oakden Report identified dysfunctional culture in the South Australian state-wide older persons’ mental health service and established an agenda for change through a codesigned culture framework. An innovative culture change project was undertaken at Northgate House, a specialist service commissioned following the Oakden Report. The project built on the culture framework, with emphasis on developing psychological safety and employed principles from the deliberately developmental organisation model. The project resulted in positive outcomes for patients and staff and valuable organisational learning. Insights from the project may inform culture change journeys in a range of healthcare settings.
What is known about the topic? There is a growing body of evidence regarding the benefits of psychological safety in the workplace. The development of positive workplace culture at the microsystem level, which is at the frontline where healthcare delivery occurs, contributes to better experiences and outcomes for patients and staff.
What does this paper add? This paper provides an example of how teams can approach workplace culture change at a microsystem level. The paper illustrates an innovative culture change program, undertaken within a quality improvement framework, engaging a whole team, irrespective of discipline or position, in order to promote psychological safety and engagement in personal and professional growth.
What are the implications for practitioners? Practitioners have the ability to generate and lead culture change at the frontline of health care. This paper illustrates principles and practices that are transferable to multiple settings and can be used by clinical leaders and healthcare practitioners to promote their own journeys of service transformation.
Keywords: health services, mental health, workforce.
References
[1] Groves A, Thomson D, McKellar D, Proctor N. The Oakden Report. Adelaide: South Australian Department for Health and Ageing; 2017.[2] South Australian Government. The Oakden Report response: the work of the Oakden Report Response Plan Oversight Committee. Adelaide: South Australian Department of Health and Wellbeing; 2018.
[3] McKellar D, Hanson J. Codesigned framework for organisational culture reform in South Australian older persons’ mental health services after the Oakden Report. Aust Health Rev 2019;
| Codesigned framework for organisational culture reform in South Australian older persons’ mental health services after the Oakden Report.Crossref | GoogleScholarGoogle Scholar | 30819324PubMed |
[4] South Australian Government. SA Health strategic plan 2017 to 2020. Adelaide: Department for Health and Ageing; 2017.
[5] Brodaty H, Draper BM, Low LF. Behavioural and psychological symptoms of dementia: a seven-tiered model of service delivery. Med J Aust 2003; 178 231–4.
| Behavioural and psychological symptoms of dementia: a seven-tiered model of service delivery.Crossref | GoogleScholarGoogle Scholar | 12603188PubMed |
[6] Edmonson A. The fearless organization: creating psychological safety in the workplace for learning, innovation and growth. Hoboken: Wiley; 2019.
[7] Kegan R, Lahey L. An everyone culture: becoming a deliberately developmental organization. Boston: Harvard Business Review Press; 2016.
[8] Razzetti G. For more productive meetings, do a mindset check in first. 2018. Available at: https://www.tlnt.com/for-more-productive-meetings-do-a-mindset-check-in-first/ [verified 2 June 2020].
[9] Clarke V, Braun V. Successful qualitative research: a practical guide for beginners. London: Sage; 2013.
[10] Edmondson A. Psychological safety, trust and learning: a group-level lens. In Kramer R, Cook K, editors. Trust and distrust in organizations: dilemmas and approaches. New York: Russell Sage Foundation; 2004. pp. 239–72.
[11] Schein E. Kurt Lewin’s change theory in the field and in the classroom: notes toward a model of managed learning. Syst Pract 1996; 9 27–47.
| Kurt Lewin’s change theory in the field and in the classroom: notes toward a model of managed learning.Crossref | GoogleScholarGoogle Scholar |
[12] Manley K, Jackson C. Microsystems culture change: a refined theory for developing person-centred, safe and effective workplaces based on strategies that embed a safety culture. Int Pract Dev J 2019; 9 4
| Microsystems culture change: a refined theory for developing person-centred, safe and effective workplaces based on strategies that embed a safety culture.Crossref | GoogleScholarGoogle Scholar |
[13] Bokhour BG, Fix GM, Mueller NM, Barker AM, Lavela SL, Hill JN, Solomon JL, VanDuesen Lukas C. How can healthcare organizations implement patient-centred care? Examining a large-scale cultural transformation. BMC Health Serv Res 2018; 18 168
| How can healthcare organizations implement patient-centred care? Examining a large-scale cultural transformation.Crossref | GoogleScholarGoogle Scholar | 29514631PubMed |
[14] Manley K, Sanders K, Cardiff S, Webster J. Effective workplace culture: the attributes, enabling factors and consequences of a new concept. Int Pract Dev J 2011; 1 1
[15] Boyle TJ, Mervyn K. The making and sustain of leaders in health care. J Health Organ Manag 2019; 33 241–62.
| The making and sustain of leaders in health care.Crossref | GoogleScholarGoogle Scholar | 30950307PubMed |
[16] Charlesworth K, Jamieson M, Davey R, Butler CD. Transformational change in healthcare: an examination of four case studies. Aust Health Rev 2016; 40 163–7.
| Transformational change in healthcare: an examination of four case studies.Crossref | GoogleScholarGoogle Scholar | 26188916PubMed |
[17] Willis CD, Saul J, Bevan H, Scheirer MA, Best A, Greenhalgh T, Mannion R, Cornelissen E, Howland D, Jenkins E, Bitz J. Sustaining organizational culture change in health systems. J Health Organ Manag 2016; 30 2–30.
| Sustaining organizational culture change in health systems.Crossref | GoogleScholarGoogle Scholar | 26964847PubMed |
[18] Frazier ML, Fainshmidt S, Klinger RL, Pezeshkan A, Vracheva V. Psychological safety: a meta-analytic review and extension. Pers Psychol 2017; 70 113–65.
| Psychological safety: a meta-analytic review and extension.Crossref | GoogleScholarGoogle Scholar |
