By: Christina Carpentier, Sterile Processing Manager, Seattle Children’s Hospital

In brief:

• You can’t wait for a crisis to find out whether your sterile processing team feels safe speaking up. Psychological safety has to be built before pressure hits.
• In sterile processing, trust allows teams to raise concerns, own mistakes and solve problems together before they impact patient care.

Understanding psychological safety beyond the definition

Psychological safety gets thrown around a lot, especially in leadership trainings. But in sterile processing, it’s not about buzzwords or best practices. It’s about creating an environment where people feel safe enough to tell the truth.

But what does that look like in a sterile processing department (SPD)?

I believe it looks like:

• A tech feeling safe to speak up about a questionable tray before it reaches the operating room (OR).
• A new hire asking for clarification on a reprocessing step without worrying they’ll be seen as unqualified.
• A lead acknowledging a mistake during assembly and using it as a teaching moment for the team.
• Staff feeling comfortable reporting workflow issues or defects without fear of being blamed.

That truth might be uncomfortable, but in an environment like the SPD, where silence can impact patient care, it’s critical your staff feels safe to speak up. 

Building safety before it’s needed most

It’s hard to know whether your team truly feels safe when everything is going well. People rarely need to speak up or take risks in smooth, day-to-day operations. The real test of psychological safety comes when something goes wrong. That’s when you find out whether team members feel comfortable raising concerns, admitting mistakes or challenging decisions.

But as a new SPD Manager, I didn’t want to wait until something went wrong to fully understand if this was true. I could already see signs of blame and miscommunication from both departments. If I wanted to create a larger culture of psychological safety to help us under pressure, I needed to ensure everyone felt supported enough to speak up before things went wrong. Because in sterile processing, the ripple effect of silence can move quickly and impact far more than just one shift.

How you know it’s missing

The absence of psychological safety can show up in subtle ways. You might notice people sticking to their lane, even when they see a problem. You might notice defensiveness in team meetings or silence after you ask a question. You might notice rising tension between shifts or across departments, where people feel like they have to protect themselves.

Like I mentioned before, I saw these warning signs when I first arrived. Staff did their work, but they avoided engagement. They avoided risk. They avoided each other. And that kind of fear-based culture cannot sustain high performance, no matter how talented your team is.

How to rebuild it when it’s broken

Restoring psychological safety doesn’t start with a team huddle or a PowerPoint. It starts with how you show up as a leader.

When I joined the department, I didn’t lead with policy. I led with presence. I rotated with the staff and asked them to teach me their process. I made it clear I was still learning too. And when issues came up, I didn’t rush to blame or fix. I listened.

Over time, we created systems that supported the same approach. For example, we started holding feedback sessions that normalized constructive criticism across all levels of the team, including leadership. We also paired expectations with support, which meant people knew what was expected and felt equipped to meet those standards.

Psychological safety is not about eliminating conflict. It’s about making it productive. It’s about getting the hard stuff on the table, so the team can move forward together.

The bottom line

If people don’t feel safe, they won’t speak up. And if they don’t speak up, you will miss problems, lose momentum and limit your team’s growth. Psychological safety is not a leadership tactic. It is a leadership mindset.