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Should violation of consumers’ emotional safety be a ‘never event’?

Should violation of consumers’ emotional safety be a ‘never event’?

We think of consumer safety primarily in terms of physical harm. But consumers often conceptualise safety as ‘feeling safe’, as well as ‘being safe’.  

Violating a consumer’s emotional safety while avoiding physical harm is not yet embedded in consumer safety reporting. We know that consumers can experience emotionally harmful experiences as they navigate health services, such as disregard for their opinion, not being listened to, rudeness and abuse. Are we doing consumers and families a disservice by ignoring or denying harm that doesn’t fit our organisational definition?

The differentiation between ‘feeling safe’, as defined through consumer experience, and ‘being safe’ as defined clinically, may create a power differential that reduces the role and value of patient experiences as valid safety indicators. If not formalised, the characterisation of ‘feeling safe’ can be easily dismissed as not a ‘real outcome’ of interest to human service organisations.

We may struggle to support effective consumer participation in safety improvement if we define safety using only a traditional biomedical model. The inclusion of consumer-reported experiences of emotional or psychological safety may significantly improve consumer participation, by opening the safety conversation to be more relevant and accessible to consumers and families. 

Recognising and reporting instances of consumers feeling unsafe is more common in some human service sectors than others; community health, mental health and paediatric care are more likely to have formal programs in place to promote emotional safety, by the nature of their work. Implementing a consumer reporting system for emotional safety is the first step. We could go further. Going further, if emotional safety breaches, such as rudeness, disrespect and psychological abuse were categorised as never events, would this make a difference across human services?

All accessed: 5/3/23

Lyndon A, Davis D, Sharma AE, et al. Emotional safety is patient safety. BMJ Quality & Safety Published Online First: 02 February 2023. doi: 10.1136/bmjqs-2022-015573