A new paradigm for developing healthcare leaders will arise from organic changes built on the strengths of our current system and engineered ones arising from interdisciplinary collaboration, discovery, and invention. In all my years working in healthcare leadership, one truth has remained constant: it’s not just a checklist—it’s the foundation of everything we do. It’s not just about protocols or compliance; it’s about ethics and how we lead, communicate, and create environments where people—patients, providers, and staff—feel seen, heard, valued, and safe.
As the healthcare landscape shifts, safety remains at the forefront of healthcare. And, one competency is becoming increasingly important: psychological safety. Its framework is a basis for how healthcare leaders act, respond, and lead. It aids in creating and maintaining safe care and safe workplaces, too. And there’s a through line from current to future that offers a way forward.
Safety: The Bedrock of Our Work, Not a Feature
Those in healthcare know that safety is at the core of healthcare care, delivery and service and isn’t just about preventing errors; it’s a guiding principle that shapes how we lead, communicate, and improve patient outcomes. Healthcare managers support safety through a broad array of functions in the healthcare sector. The WHO Patient Safety Charter (2024) reinforces this, emphasizing safety as a universal healthcare right. From the frontline to C-suite, upholding safety standards and continuously improving are deeply valued and ingrained in healthcare management.
Current interest in safety gained momentum in the late 1990s with the landmark report To Err is Human by the Institute of Medicine (IOM). This report highlighted preventable deaths and led to key industry shifts, including structured review processes, increased transparency, and patient education campaigns like The Joint Commission’s “Speak Up” initiative. These changes strengthened accountability among clinicians and management while amplifying the patient’s voice in their own care.
Our Very Human Need for Safety
Underpinning all of the work and progress in safe care and a safe in the healthcare environment is psychological safety—a workplace culture where individuals feel empowered to share ideas, concerns, and mistakes without fear of punishment. Harvard researcher Amy Edmondson defines psychological safety as “a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes.” In high-risk fields like healthcare, this is essential for fostering collaboration, reducing errors, and driving innovation.
A psychologically safe workplace enables healthcare teams to:
- Speak up about concerns without fear of retaliation.
- Learn from mistakes through open, solution-oriented dialogue.
- Challenge outdated practices that compromise patient safety.
- Innovate by fostering continuous learning and improvement.
The Leadership Imperative
As healthcare becomes increasingly complex, future leaders will need psychological safety as a core competency more than ever. But how do we cultivate it? In my experience, a few practices have proven successful and resilient:
✔ Emphasize Inclusion. When making decisions, ask: Who is at the table? Are diverse perspectives represented? Create spaces for open dialogue and fresh insights.
✔ Lead with Vulnerability. When mistakes and errors occur, ask: How did we make this mistake or error? Become a part of the situation, listen, learn, and work to understand. Model vulnerability, avoid blame, and collaborate to improve processes and systems.
✔ Think Beyond Transactions. When solutions are needed, ask: How is this one transaction or immediate issue connected to the larger goal of our work? Psychological safety results from making connections between short and long-term relationships among people, processes, and outcomes. Leaders who understand how psychological safety connects with operations, technology, and patient outcomes engage, enable, and empower others, and by doing so, they build trust.
A Through Line and Path Forward
A robust and growing body of literature and an increasing number of healthcare organizations have shown that prioritizing psychological safety improves patient outcomes, reduces medical errors, increases staff engagement, and increases staff retention. The recent global report by the World Health Organization (WHO) attests to the importance and power of embracing safety as a core value and psychological safety as an essential element.
As we integrate AI, personalized medicine, and evolving workforce models, our success will depend on creating and maintaining human-centered environments where healthcare staff/professionals feel heard, valued, empowered, and safe to “speak up” and lead change. Much work is underway, of course, but the demands of the healthcare environment are ever-present and distracting, making it an ongoing challenge. Using our collective intelligence and expertise across disciplines strengthens our position, our resolve, and enables us to prepare focus on developing future leaders for the inevitable disruption, change and challenge they healthcare delivery system where technology becomes more prominent.
At Leslin Healthcare Leadership Foundation, we believe that psychological safety is fundamental to preparing the next generation of healthcare leaders. We are integrating psychological safety competencies into human-centered leadership principles through research, education, and collaboration to create a new paradigm for healthcare management. Integrating psychological safety into leadership development prepares leaders and teams and contributes to shaping the future of healthcare.
A call to action: Promoting competencies in psychological safety is crucial for future leaders. What key steps are we currently taking, and what actions can we take to develop these skills further?