Physical, psychological and cultural safety

Health care systems and health care workers across Canada place significant emphasis on the needs, care and safety of their patients — such is the nature and the culture of the field. The health, safety and protection of health care workers is also important, as safety for health care workers is safety for all, but their well-being is often neglected. According to the Canadian Charter of Rights and Freedoms, Section 7, security of the person is a constitutional right, but many health care workers in Canada today operate in high-risk environments that increase the risk of harm and abuse.

One of the first initiatives to be launched in line with the CMA’s Impact 2040 strategy is the creation of a Pan-Canadian Health Workforce Framework for Physical, Psychological and Cultural (PPC) Safety. The impetus for this initiative is to address the existing variability and gaps in safety in health care learning and practice environments, which contribute to poor provider wellness, organizational performance and clinical outcomes.

What is safety?

Safety involves the presence of certain factors:

• An outcome or state of being marked by various requirements including:
  • Feelings of trust and comfort
  • Ability to express and be yourself according to your values
  • Mutual respect and understanding

Safety also involves the absence of certain factors:

• An outcome or state of being marked by the absence of various factors including:
  • Absence of harm and discrimination
  • Absence of unjust retribution
  • Absence of the consequences of power imbalance or misuses

Physical safety is the result of an environment free of harm or injury, threats of harm or injury, or near harm or injury, which may be inflicted by a person, substance, object, hazard or occupational practice.

Psychological safety is a climate of trust and respect in which people are comfortable working to their full scope of practice and hold the belief that teammates and leadership will not embarrass or punish a colleague for speaking up in the line of work.

Cultural safety is an outcome based on respectful engagement that recognizes cultural preferences (e.g., customs, rituals) and strives to address inherent power imbalances in the health care system. It results in an environment free of racism and discrimination, where people feel safe to express themselves.

Learn more about wellness through safety and creating safe, inclusive and health-promoting learning and practice environments through these resources:

• The Physician Wellness Hub’s resources on Physical, psychological, and cultural safety
• Join the Health Workforce Community in the CMA’s Community Platform
• The CMA’s Framework for physicians’ physical, psychological and cultural safety