In an American study comparing quality between health care teams, researchers expected teams who made few mistakes to provide the best quality. Researchers were surprised to find that teams who reported more mistakes saved more patients.

When they studied this closer, they found that in fewer-reports-lower-quality teams, people hesitated to point out problems because they didn’t want to be blamed, or to be seen as negative. Only the most obvious mistakes were reported, so there were few opportunities to learn from.

In contrast, in teams who reported many mistakes, there were positive attitudes around finding mistakes or problems – it was seen as an opportunity to learn and make improvements. All team-members searched for problems, discussed them with each other, and reported anything that could become a risk for patients. They had plenty to learn from.

The successful teams had what is called psychological safety. In this environment, people felt comfortable talking about problems and mistakes, asking questions and sharing thoughts. This clearly made them different form the less successful teams.

There was also another difference: Ambitions were high in successful teams, so people were prepared to make the effort to learn and make improvements. When ambitions are low, things will just stay as they are, because it’s easier.

Let’s leave the health care research and think about NCAB. When we combine these two factors we get four zones:

– The passive zone, where ambition and safety are both low.

– The comfort zone with low ambitions and high safety – a nice place, but not much action. This is a Red Ocean place.

– When ambitions are high, people want to explore, but if the psychological safety is low, they will be very uncomfortable doing it – that’s the anxiety zone. This is an unhealthy place; we don’t want that.

– Finally, the zone that combines high ambition and high safety. The researchers coined the name “learning zone” for this mental environment where the highest quality can be achieved, and improvements are constantly made. Sounds relevant for NCAB, doesn’t it? A Blue Ocean place.

I’m sure you can see how the learning mindset fits right in. That everyone must paddle is a high ambition, and we don’t want people in the anxiety zone. We need high psychological safety at NCAB, for openness and exploring, or there will be no paddling.

Creating this safety is everyone’s job. Without thinking about it, someone can easily make their colleagues feel less safe just by making fun of an idea or a question, even if they mean no harm. Instead, you can make others feel safer by, for example, admitting a mistake you made or asking for advice, by openness and exploring. Your behaviour will make a big difference.

It’s quite difficult to speak openly about problems without making people nervous and defensive, but it’s an important success factor for a team. And it cannot be handled by the manager alone – everyone must help.