The term “team” is not often used in pharmacy circles when describing dispensaries and staff, yet our dispensaries are typically made up of a small to medium sized group that works closely together day after day, needs to be able to communicate and cooperate efficiently and work with a common purpose and goals.  This is pretty much the definition of a team, and how effectively the team works together will be reflected in how happy staff are in their positions,  how productive the team will be and the level of care provided to people walking through the door. 

Pharmacy practice requires high functioning teams which are efficient, cohesive, focused and high performing.  Productivity is at its highest when teams perform as a cohesive unit.  Yet not a lot of attention is paid to how our dispensary teams are functioning and whether or not improvements could be made which would increase job satisfaction, employee retention and improve patient care.  With so much riding on the outcome, it doesn’t make sense to leave successful team member interaction to chance.

Google’s five year study on highly productive teams, Project Aristotle, found that psychological safety was “far and away the most important of the five dynamics that set successful teams apart.”  What does this mean?  In a team with high psychological safety, teammates feel safe to take risks around their team members. They feel confident that no one on the team will embarrass or criticize anyone else for admitting a mistake, asking a question, or offering a new idea.

Harvard Business School professor Amy Edmondson in her book “Teaming”, states that psychological safety is “a taken-for-granted belief about how others will respond when you ask a question, seek feedback, admit a mistake, or propose a possibly wacky idea.”

A few common scenarios in pharmacy can demonstrate what a lack of psychological safety looks like:

• When a mistake is made, team members look for blame rather than supporting those involved and looking for ways to improve and prevent future incidents.    
• When there’s a challenging clinical decision to be made, pharmacists hesitate to ask each other for their opinion because they’re afraid to look like they don’t know the “correct” answer.  In reality, checking in with a colleague for “what would you do in this situation” is an immeasurable tool for professional growth.
• When a staff member is not present and others discuss or critique them, or a scenario they were involved in, rather than addressing the issue with the person involved with positive intention and empathy. 

Maintaining psychological safety in a team requires a strong leader who will pick up on any tensions or situations in which vulnerability and safety is being damaged, and then be confident enough to address the situation and bring the team back into alignment.  Skills in interpersonal management,  healthy conflict resolution, strong self-awareness and emotional intelligence, and empathy are essential. 

Normalizing certain behaviours in a team is also critical, such as apologizing and backing that up with behaviour change, expectations on how we treat each other and communicate with one another, assuming positive intentions, demonstrating respect and maintaining accountability. 

It is important not to mistake safety for comfort.  Psychological safety does not mean a cozy situation in which people are close friends and there are no pressures or problems.   Often times maintaining psychological safety in a team is not comfortable.  For example, instead of ignoring gossip, bringing it to light and addressing the issue is not typically comfortable, but it is crucial in order to resolve the hard feelings and division gossip can cause.  The end result is a stronger team who understands they can come to their leader with issues and have them addressed with equanimity. 

Edmondson, Amy C. Teaming: How Organizations Learn, Innovate, and Compete in the Knowledge Economy. Jossey-Bass, 2012.
Brown, Brené, Dare to lead: Brave work. Tough conversations. Whole hearts.New York : Random House, 2018.