Narrative Leadership: Signaling Safety and Inclusion Through Storytelling

Improving the quality of care performed by interprofessional teams has been a complex problem in health care for years. Progress has been made with the adoption of formal quality improvement measures; however, success has been slower and more variable than anticipated. Research shows that relational issues, not technical problems, are more often impairing the success of quality improvement initiatives (1). In fact, improvement efforts often overemphasize technical approaches, to the detriment of relational ones, when evidence supports that relational factors are more impactful on interprofessional team-based care. The highest functioning teams focus on and excel at both technical and relational elements (2).

Of relational factors, psychological safety – the shared belief that team members can take interpersonal risks (3) – is increasingly recognized as essential to high functioning teams and high quality health care. For example, hospitals with increased psychological safety experienced significantly greater reductions in risk-standardized mortality rates following acute myocardial infarction (4). Cardiothoracic surgery teams at an academic health center found that enhanced psychological safety significantly decreased surgical errors and nurse turnover at 12 months (5). In our work in various clinical, educational, and research settings, we hear how important it is that individuals feel empowered to contribute in all situations. Psychological safety matters. Systems leaders articulate a desire to create psychological safety, but all too often academic training falls short of equipping healthcare professionals with the practical day-to-day skills to create this type of working environment.

The COVID-19 pandemic has highlighted the urgent need for promoting safe, inclusive, and human-centered healthcare and learning environments. The pandemic has exacerbated the strain on our relationships with patients, learners, colleagues, and interprofessional partners. More than ever, we need collaboration that honors providers’ humanity and builds upon their strengths. Substantive improvement requires an activation of leadership’s relational domain, and the cultivation of a psychologically safer culture. Despite increasing awareness of the importance of psychological safety, we are still learning how to make it both actionable and impactful.

Engaging in Narrative Leadership, utilizing storytelling as a leadership tool, can enhance psychological safety in interprofessional teams. This session gives attendees practical skills to enhance psychological safety within their teams and communities and move this key concept from a theoretical good to an actionable essential.

In this seminar, attendees will experience a brief, interactive introduction to psychological safety. Then, we will transition into skills training on Narrative Leadership, a tool that can enhance psychological safety, through a short didactic, a live demonstration, and then small group practice. A debrief and discussion of application will round out the session.

Learning Objectives:
1. Identify the role of psychological safety on highly functioning teams and the delivery of high quality patient care.
2. Determine how employing the principles of Narrative Leadership contributes to a psychologically safer team environment.
3. Apply Narrative Leadership in appropriate settings to demonstrate shared values.
4. Develop a Story of Self for use in professional settings.