Change the world with policies? Whatever.

These last two weeks have been busy ones, but as always filled with interesting conversations, ideas and debate. I am only a week away from my first co-presenting opportunity sponsored by Thought Architects (thank you Vered!) and have been busy readying myself for that. This week I felt a bit stuck in what to share. Vered Levant, Thought Architect’s Senior Director and #HRguru was talking about how there are relatively recent changes to Alberta’s Occupational Health and Safety (OHS) Act aimed to prevent and manage incidents of harassment and violence in the work place (http://www.qp.alberta.ca/1266.cfm?page=O02P1.cfm&leg_type=Acts&isbncln=97807798). These changes from June of 2018 mean that employers must ensure workers are not subject to or participate in harassment or violence in the workplace, and that supervisors and workers support that goal. There must also be a way to assess risk and put a prevention plan in place. She has noticed that many small businesses are still working to adopt these new requirements.


This caused me to think about the average small business owner in healthcare – a clinical physician. The word “overwhelming” keeps coming to mind. As small business owners in medicine there are an endless amount of things to consider: leases, operations, staff, legislation, payroll, team effectiveness, morale, retention, clinical improvement, college requirements, navigating the system and…oh right – seeing patients. Isn’t that what doctors are supposed to do? While I applaud the government for amending legislation to protect workers, rarely is legislation a leading indicator of success. It just becomes one more thing to do.


Then I started thinking about how to actually impact change in an environment that results in real change – change that provides the confidence that workers, and you, are actually safe. This means there has to be a culture of people feeling heard and supported, which creates both the respectful workplace that fosters a positive culture and the allows for the conditions for staff to report incidents and issues. While there is a need to comply with the legislation and ensure that the policies and procedures are in place, rarely do policies and procedures impact culture (my good friend Marlies at The Pivot Group could entertain you for hours on this topic). Marlies also looks at leadership and change in different ways – check her out at www.thepivotgroup.ca/). Policies, working groups, committees don’t make change. At a clinic level and as a small business owner, this is no surprise to you.


So what does shift a culture? How could you create an environment where you are confident that the intention, not just the letter of the legislation is achieved? How do you create a psychologically safe environment for everyone? It actually starts with changing the interactions and how we engage. Let’s look at the science of feeling safe. You feel safe when your amygdala is not triggered. The problem is that it gets triggered with even the slightest indication of a threat, and we see many behaviours as threats. Managing this threat can be countered by keeping the more rational prefrontal cortex engaged. Appealing to the cortex is really at the heart of the concept of “psychological safety”. Promoting a “safe” environment means enacting specific behaviours in interactions and patterns of social relationships. David Rock’s (@davidrock101 ) book – Your Brain at Work – is (IMO) groundbreaking in its science and understating of the brain. As social creatures, we need to have our status maintained, we need to have a degree of certainty, a sense of autonomy, feel connected to others and a sense of fairness. If any of these are out of whack, we sense a threat. Think back about one of the worst environments you ever worked in. Which of those areas were under threat? Did you feel safe? You likely did not, and neither did others. There goes the culture.


Creating safe environments is really about the “invisible” adaptive skills of communication, engagement and fostering others thinking in a psychologically safe way. Safe environments for these interactions are characterized by the ability of individuals to collectively grow, plan, reflect, solve problems and create a deeper connection (Costa & Garmston, 2016).


As a small business owner, it really starts and ends with you. In discussions with many providers, those who were able to create safe, caring environments focused on their own interpersonal leadership journeys. While time away from the office and not seeing patients is hard to manage, losing your team, dealing with a harassment claim, working in an environment where others are not happy, being stressed and burned out is much worse. Think of building your leadership and team skills as part of the long-term investment in your business (and you) and ask yourself – what is the cost if I neglect me?

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