Resources

Saying sorry is an important element of open disclosure and psychological safety – and therefore clinical governance. It is also an extremely powerful yet simple way to make people ‘feel better’. Saying sorry conveys empathy, compassion, and respect towards the person receiving the apology, not to mention remorse. It acknowledges an acceptance that your actions (or words) can adversely impact others, and is the opposite of defensiveness (which is counter-productive). Apologising is not taking the blame, nor is it an admission of liability. Saying sorry is about being accountable, accepting responsibility, and restoring trust in a relationship.

It’s not just what we say, it’s how we say it. We know effective communication is key to patient safety and quality, and person-centred care. But it is also crucial to psychological safety and the extent to which we support each other in speaking out, or in asking questions. This in turn will impact patient care.

Professional boundaries in healthcare delineate the therapeutic relationship. They have been defined as ‘parameters that describe the limits of a relationship in which one person entrusts their welfare to another and to whom a fee is paid for the provision of a service’ - or, more broadly, as the ‘edge of appropriate clinical care’.

In part two of this two-part webinar, Dr Duncan McKellar talks about where to start when developing a cultural framework in the context of compassionate, relationship-centred care. Dr Duncan McKellar will talk through the sequence of events needed, citing the three-phase project plan adopted for Northgate, and the practicality of cultivating psychological safety.

The Royal Commission into Aged Care Quality and Safety noted in its Final Report, presented on 26 February 2021, that aged care ‘should be able to deliver compassionate and kind care built on respectful relationships’. Person-centred care (or ‘consumer-centred’ care) was already central to the way aged care was expected to be delivered, under the Aged Care Quality Standards which have been in effect since 1 July 2019.

In the context of aviation, Bienefeld and Grote defined ‘speaking up’ as ‘an upward voice directed from lower to higher status individuals within and across teams, which challenges the status quo, to avert or mitigate errors.’ 

In childhood, we shun the ‘dibber dobber’, or the ‘tattletale’. As we mature into adulthood, we learn to distinguish ‘dobbing’ from an acceptable calling out of wrongdoing. However, in the context of care giving (whether healthcare or otherwise), speaking up is crucial to safety.

How are clinical information systems relevant to clinical governance? The answer is quite straightforward: imagine a world of care delivery in darkness (literally or metaphorically), absent of any information about the person for whom you are providing care.

Over two webinar events, Duncan McKellar steps us through the practical application and benefits of embedding psychological safety at the frontline, drawing on his life-changing involvement in culture reform post The Oakden Report. Join us for part 1: Restoring humanity through a psychological safety approach.

The term ‘clinical governance’ was first coined in the context of the National Health Service (NHS) in the United Kingdom, being ‘a system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.'