Like many others, as we move into the recovery phase of the pandemic, I find myself reflecting and processing the experience of the last two and a half years.
Prior to the pandemic, I was in leadership roles dedicated to quality and safety leadership in healthcare. A big concept that was emerging around 2017 was ‘joy at work’ and how this was linked to the quality and safety of care delivered. Papers were published, models were updated and change agents like myself contemplated how to cultivate ‘joy at work’.
In early 2020, Covid was declared a pandemic, and literally brought us all to the knees of Maslow’s hierarchy of needs (a model that explains the human needs to move an individual from surviving to thriving).
Our attention was consumed by the need for safety and security. Very quickly discussions of ‘joy at work’ shifted to crisis-fueled discussions of ‘safety @ work’. Many of us, in particular leaders, had spent little, if any time at the bottom rungs of this triangle. That is not to say that we had not faced adversity in the workplace, but when our sense of safety and security was threatened, most would ‘bounce’ to a different team or area where our personal sense of safety and security was restored. We took pride in our resilience or ‘grit’. COVID forced us to really hunker down in those bottom rungs of Maslow’s triangle, and spending time there revealed some uncomfortable truths.
Many in our workforce have never felt safe at work. Colleagues, friends…and many of us had no idea. And it is not just due to individual ignorance – the fact that the majority of healthcare initiatives were focused on ‘joy at work’ suggests system level etiology.
“Every system is perfectly designed to get the results it gets.” ~ Deming
Lack of a safe reporting culture in healthcare workplaces (and I suspect many other organizations) has created a pervasive culture of silence. Silence in healthcare, where the top contributing factor to medical errors is breakdown in communication. Is it any wonder that we haven’t moved the dial on the alarmingly high rates of medical error revealed in the 1999 report, to Err is Human?
Indeed ‘joy at work’ offers powerful protection against burnout, however we have a lot of work to do before we get there. It was validating to see the call for trauma-informed workplaces published in the Harvard business review in March 2022. We need to recognize that people have been and continue to be harmed in our workplace. Bullying, harassment, discrimination, workplace violence, racism, micro-aggressions, are as pervasive as the culture of silence.
Organizations need to look very critically at their reporting systems and processes. Groups and committees overseeing them need to lean into discomfort and do the messy more difficult work of building a safe reporting culture to support these systems and processes. To get this right, we will need people at the table who have spent significant time in the bottom rungs of the triangle to share their experiences. And we need to listen…really listen.
The skills we need today are the highly refined skills of communication – and they matter more than ever.
If we went our workforce to all have the privilege of experiencing ‘joy at work’, we need to co-design a safe reporting culture with the people who have been trapped in the ‘surviving’ level. Leaders need to acknowledge harm in the workplace, apologize, and embark on a personal journey to become trauma-informed leaders.
Join us in one of our events as we support leaders in this journey!