Psychological Safety as a Mediator of Relational Coordination in Interdisciplinary Hospital Care Units
Date of Award
Master of Arts (MA)
D'Urso, Scott C.
Fyke, Jeremy P.
Griffin, Robert J.
This thesis presents an examination of the relationship between psychological safety and relational coordination within interdisciplinary health care teams. Based on previous research, a model is proposed in which psychological safety--the perceived safety of interpersonal interaction--partially mediates the link between the relational dimensions--shared goals, shared knowledge, and mutual respect--and the communication dimensions--frequent, accurate, timely, and solution-oriented communication--of relational coordination. The proposed model was tested using multiple linear regression of survey data from 158 obstetricians, anesthesiologists, and nurses who work in the labor and delivery units at two large teaching hospitals. The findings do not support the proposed model; however, an alternative model in which psychological safety is an antecedent to rather than a consequence of relational quality is well supported. Building on these findings, the potential existence and nature of a new cluster of relationship-supporting communication dimensions is discussed.
This study also demonstrates the utility of role-level assessment of the psychological safety and relational coordination constructs. In most studies these constructs are assessed at the group level to facilitate comparisons between work groups. However, the role-based data collection and analysis applied in this study identified significant differences in the psychological safety, relational quality, and communication quality measurements with respect to various role-based subsets of the studied work groups. Additional differences were found when both the respondent's role and the role of the individual with whom the respondent was interacting were used as grouping variables. The revealed patterns of differences suggest that psychological safety and the dimensions of relational coordination are influenced by several role-oriented characteristics such as hierarchical status or control as well as a role's centrality or connectivity within an organization's social network.
The methods and findings presented in this thesis offer small steps toward the greater understanding of the dynamics of high-performance work groups. The practical application of this research includes the development of interventions designed to improve the communication, teamwork, and performance of groups in demanding environments such as hospital care units.