How psychological safety at Alder Hey Children’s hospital saved a life

Teams involved in life-and-death situations cannot afford to fall into the statistic that two in five colleagues at work feel unsafe to share ideas and voice their concerns openly.

From having a Staff Advice and Liaison Service who have already supported 2,000 colleagues; measuring how psychological safe their teams are; and facilitating open dialogue cross-functionally between paediatric surgeons, oncologists and their innovation teams, Alder Hey has a culture ahead of its time and zero time for complacency.

As a child who spent a lot of time in hospital, I was apprehensive about visiting Dr. Jo Potier, Jo Minford and Kerry Turner at Alder Hey. From the moment I walked in though something was different. No hospital smell, animated signage, incredibly helpful, hospitable and friendly staff that had time for you. You simply do not feel like you’re in a hospital. It meant none of the anxieties I experience when I go into a hospital returned.

There are so many stories to share, just one for now on the team’s approach to one of the four domains of psychological safety, ‘a team’s approach and attitude to risk & failure’.

In 2019, a six-year-old girl had a tumour in the pelvic region and was given 6-9 months to live. Scans deemed surgery would be complicated due to the tumour’s position obstructing her kidneys, spanning major blood vessels and multiple vital nerves. I was told how lonely a paediatric surgeon’s life can be especially when the odds of success are stacked against them with a life at stake. While still in its relative infancy, the team employed 3D printing and sought several points of view across the innovation, oncologists and paediatric teams to illustrate the complications and risks and included the family in decision making which culminated in a risky operation.

This is a great example of how identifying issues and problems can be an individual and lonely pursuit at times, but solutions are a team sport requiring open, honest and candid conversations. In my experience, too many leaders opt for the phrase with their teams, ‘don’t come to me with problems, come to me with solutions’. This risks suppressing issues, denying us the opportunity to address them sooner. I am not suggesting colleagues should not show initiative and have ideas, but you can see the problem with this ‘management speak’ if you really think about it.

Jo Minford, the Consultant Paediatrician, set a clear goal with the best interests of the patient at heart, including the challenging conversations with the child’s parents. She invited the participation of the innovation team, oncologists and colleagues in her own team. And critically responded appreciatively to all input before they concluded how to operate.

Today the little girl is 12 years old, over six years in remission.

There’s much more to share from visiting Alder Hey on another day. The team are so impressive, constantly striving for improvements, measuring psychological safety and remain their own biggest critics that psychological safety is not a destination but an infinite game.