Building High Performing Healthcare Teams:
Psychological Safety, Trust, and Feedback

Transforming Healthcare Coaching Podcast — Episode 91: Building High Performing Healthcare Teams. Host: Lillian Liang Emlet, MD MS CHSE CPC ELI-MP, with Transforming Healthcare Coaching® coach Gillian Faith, MS ACC SHRM-SCP CPQC. Published January 12, 2026.

Lillian Liang Emlet: One question — asked the right moment — could save a patient's life.

Gillian: The higher performing teams actually made more errors.

Lillian Liang Emlet: Leaders often don't mean to be so unsafe. The reality is, I sometimes see is they get real defensive.

Gillian: As leaders, we don't know all the answers and we shouldn't have to think that we have to know all the answers all the time. Asking for feedback, we sometimes forget to do that as leaders, we're scared of what might be coming at us, but just having that open door policy and being able to listen, to really hear what's going on, I think is very important.

Lillian Liang Emlet: So Welcome to the Transforming Healthcare Coaching Podcast. I'm your host, Lillian. Today I am joined with Gillian Faith. So how are you doing this New year in 2026, Gillian.

Gillian: Good. Thank you. How are you?

Lillian Liang Emlet: Doing well. Can't believe it's 2026. It's interesting times in the world.

Gillian: Absolutely.

Lillian Liang Emlet: And so before we dive in, what's energizing you? What is bringing you fresh energy in your work as a coach right now?

Gillian: I have to say that what brings me energy is when I work with individuals or teams and I see a shift in their thinking or a shift in the way they work together, that then leads to a positive outcome that then provides value to either the team the people or the services that the team is there to provide.

Lillian Liang Emlet: Yeah, it's really amazing to bear witness to that. So for everyone listening, this is what we're going to tackle today. The research is clear that high performing healthcare teams share very specific characteristics, psychological safety, shared mental models, and clear coordination. But the gap between knowing this and actually building it as a leader and as a follower. That's where teams usually get stuck. And so we are going to spend some time deconstructing how we develop high performing healthcare teams. And so Gillian, when you walk into a healthcare team that's really working well like this, that's just jiving. Everyone knows their high performance. And these can be administrative teams or clinical teams. What do you notice first?

Gillian: One of the first things that I would notice is how the leaders showing up and in high performing teams or teams that are creating, high value for their clients, for their patients. There's trust and the trust is coming from the person in charge. So having trust, and also we hear a lot about psychological safety. It's very, very important. And trust is, you know, the core of psychological safety. And you may be familiar with Amy Edmondson's work, where she did a study in hospitals and she looked at how teams performed. And the higher performing teams actually made more errors than the ones that were, performing at a lower level. And the reason for this is that the team members felt more comfortable admitting when a mistake had been made or saying they didn't know. Or actually disagreeing with somebody or challenging the person who's in authority. So I think in observing high performing teams, the trust and the psychological safety is very, very important.

Lillian Liang Emlet: I'm hearing what you're saying, because I think the worst thing that always can happen whenever, like a bad outcome has happened or afterwards, is when everyone's sheepishly looks down at the ground and they're like, "I guess I probably should have said something..." or "I probably should have spoken up..." or "I actually noticed something." And then you realize, you kick yourself like, "Why didn't I say something?" Whenever like it comes to that psychological safety, how do you craft that as the team leader or as the one of the members of the team? Is there anything that anyone can do to make it better?

Gillian: Yeah, there are things we can do to make it better and I would encourage leaders to do things like ask for feedback. Be open to feedback and actually listen to it. Then you're creating a culture of giving and receiving feedback and let's face it, a lot of people don't like to receive feedback. They don't like to give it, and it can be uncomfortable, but it actually is very, very important and normalizing that makes such a difference on a team. So that's definitely one thing.

Lillian Liang Emlet: I'm wondering, you know, too, like whenever I think about really good feedback, it's quick, precise, no biggie. I don't think any more or less of you as a person, because of it. And it's just like, "Hey, point it out and just move on. Like, friend to friend, like,

Lillian Liang Emlet: "You have lipstick on your teeth..." or something. Just tell me like, it's there. Like, if you cared about me, you tell me. And so I think it's always really interesting, when you notice that people can do that, especially, when it comes to things they notice that are happening in the room. Because I'm so grateful, in some days, the chaos, if someone just really tries to tell me what's happening, sometimes it takes like three times and I clearly am not listening. I'm glad for the persistence for some people.

Gillian: Yeah, or having a quick debrief afterwards and just quickly recapping what could have gone better, what could we maybe do the next time?

Lillian Liang Emlet: Yeah, it's funny that you say that about feedback. You are so right, people are really terrified of feedback. We often say that we don't get good feedback. We are afraid to give it. We're afraid to receive it. In fact, there's like a litany of feedback books and we probably should talk to an episode just on feedback. But I'm curious if you have any tips in terms of how to get over that fear of being humiliated or fear of being embarrassed in front of people and just all that fear that actually is the real reason underlying why the feedback is never given or is awkward.

Gillian: Yeah. And giving feedback, if it's an individual, you always want to do it in private. You don't want to do it in front of other people. But there's going to be other times where feedback to a team or a group or, and just discussing what really happened is completely appropriate. Again, I'm going to go back to the creating the culture of normalizing giving and receiving feedback because if it's as a leader, we communicate that it's expected and it's part of what we do, and it's part of how we show up, then it takes some of that emotion away and it takes some of that fear around being, like you say, judged or, or whatever. If we need to give somebody feedback, sometimes it's really nice to just take them aside and just say, "Are you open for a discussion on what just happened?" I just maybe asking their permission just to get into the conversation always helps. It's not always the best way to go, but it's just one way to do it. And also,

Gillian: we did a session on Radical Candor with Kim Scott's textbook on that. And with Radical Candor, you want to show the person you're giving feedback to, that you care about them personally, but then you want to give them feedback directly. If they know that it's coming from a good place and you, they feel that you do care, they will receive the feedback in a much more positive way.

Lillian Liang Emlet: No, it's true. It's always like, I really want you to look good as a leader, and I just need you to know that when you speak this way to a particular nurse, like this is just, that's not acceptable. You make everyone afraid of you, and that's actually feedback I've received from a colleague of mine. But it is, it's true. So you gotta say hard things and you gotta say it's also unacceptable. Like the way you're behaving is not right. You need to tone it down. And then, I mean, I heard it. I heard it immediately loud and clear. So I'm really grateful for the nurse that told me that. But it's hard, it's really hard to have the bravery and the courage to do that. And I think generationally that people recognize that they do have that opportunity. I do sometimes worry that there's a lot of fear between hierarchy, disciplines, culture, race, like you don't know, "Is it okay?" Because there is a lot of fear for retribution, unfortunately, I think as the hidden secret behind everything. They're like, "Oh, what if this will get back?" Or "What if I don't get promoted because of this?" Or "What if I get a reputation?" even worse. I don't know if you have any thoughts for that.

Gillian: not specifically, but that's coming right back around to the psychological safety again.

Lillian Liang Emlet: Meaning the, if you just explain to everyone, the way I like to run my ship here in this department is that it's okay to give feedback and I will give you potentially feedback by the end of your shift every single time. And it's also okay to speak up for what you need. And it's okay to tell people to just be able to just voice that is what I'm hearing you say. Absolutely.

Gillian: And help people become more comfortable knowing it's not actually a nice to have. It's actually an expectation of working here, and we're going to listen to it.

Lillian Liang Emlet: My trainees and fellows and students have told me for years 'that the culture of safety isn't always there for speaking up like this. And if you're sitting with a leader who feels like their team doesn't feel safe speaking up, what do you see in the moment? Like in the coaching session, when you're coaching the physicians or the nurse leaders, and they basically are grappling with, they just received feedback that they are not safe, and they don't create that environment for people. Like what do you see in them? What's it feel like?

Gillian: I think what we would be seeing in a client or a leader like that is, perhaps they're struggling with how they're showing up as a leader, right? How they're... Do they feel like they have imposter syndrome where they don't feel like they have, you know, they may have all the skills that they need, but they don't actually recognize that. So how do they feel in their leadership position? Where are they leading from? Do they have some fears around what's maybe happening?

Lillian Liang Emlet: Yeah, no, I would totally agree. I do. It's funny, whenever we do some of our workshops and when we try to talk about this and deconstruct it, many of the faculty in the back are like, "Well, sometimes we are not really well. Like, we are stressed out." Just like you said, the imposter syndrome, the not sure what to do. You feel helpless, you feel frustrated. Leaders often don't mean to be so unsafe. And at the same time, the reality is, the other thing I sometimes see is they get real defensive. Really defensive really quickly in terms of excuses trying to explain away why they behave that way. Making it is the system's fault rather than recognizing there is, if you are well and able and confident and whole and okay in that moment, then you have the capacity to be able to receive hard feedback, right.

Gillian: Yeah. And as leaders, we don't know all the answers and we shouldn't have to think that we have to know all the answers all the time. And I think in healthcare, especially in your role as a physician, you're expected to know the answers right when you're dealing with patients. But there's other times when, as a leader you may not know all the answers when it comes to leading a team or how to show up for your team. And perhaps some help around that would be beneficial to the leader in the team.

Lillian Liang Emlet: Right. Yeah. Which is why I think why we often try to shift from that defensive feeling helpless or really unsure or feeling imposter instead of shifted to moving towards how can you be more curious? How can you be more wondering? Because I mean, it is true, it is kind of, you feel sort of stupid to say that you don't know something or you're not sure, and you also feel like that's not what the team needs. Like great, like, so I don't know what to do. I mean, like if I think back in the pandemic that's terrible to think that we don't know what to do. You want to know what to do. And so the question is asking more questions helps everyone get there together.

Gillian: Yeah, and then being able to really listen to what's being said.

Lillian Liang Emlet: Yeah. So I'm wondering for the leaders who are listening right now and thinking, "Yeah, this, something happens on my team and oops! I actually have a direct report that might sometimes behave this way, and there may be some opportunities for me to maybe suggest some things to shift that dynamic to make things more safe." Do you have any ideas or tips that you would suggest for people who either are a new leader or have direct reports?

Gillian: Yeah, I think it's important to have a mentor. If you're a new leader, a mentor, or be working with a leadership coach or be in some kind of working on leadership development.

Lillian Liang Emlet: Yeah, I totally agree. I think having mentors and accountabilities and role models is really important. And then I think the other wonder is I often also think that sometimes we don't know who to debrief with. So I think sometimes, to get along with your point, we don't know who to talk with about these situations, which is why I do think that many leaders find coaches, because who are you going to talk with about it? If you may or may not have someone who's assigned as a mentor in your organization, then you need to go find the support that you need.

Gillian: Yeah. And the coach can provide a safe, confidential space. And it's non-judgmental, so it's okay to just let it all out and then take it from there.

Lillian Liang Emlet: Yeah. So we have this idea here at Transforming, about "changing teams, one person at a time. And changing healthcare, one person at a time." And so, could you walk us a little bit about how you sometimes see this play out? What's it look like when one leader just starts to shift their approach?

Gillian: So that can be, you know... I'm just going to use the word transformational and which is, it's a big word and it can mean lots of different things. But, the way a leader shows up in terms of communication and how well the team is aligned to be part of a cohesive team, the communication has to be right. The alignment has to be right, and the psychological safety has to be there. So if that is not present in a team and a leader can shift to embodying those values, you can certainly see a shift in the team.

Lillian Liang Emlet: Right. And so, other things. I've noticed that whenever leaders begin to think like their coach a little bit and you start asking questions, so, I don't know. I still always remember there was a moment, like early when I had my first coach. Like she'd ask me questions and then I'd wonder about things. And it's almost like you could hear that person's voice later, right? When you're in the moment, you're just like, "What would so and so say?" Or "What would so and so be telling me to think?" And then next thing you know, you're like, let me just try to think of a question to be more expansive and more curious, in that moment, so that people have opportunity to say things.

Gillian: Yeah, and, you know, being curious and asking more questions, if there is, you know, tension or conflict on a team or between two, even just between two people, it can really help open that up and it can really help build relationships based on deeper connection.

Lillian Liang Emlet: Yeah. You know, in the reference back to Amy Edmonson's book "The Fearless Organization and Creating Psychological Safety in the Workplace", I do think that it's like these tiny little changes when like once one person on a team starts to be a little bit different on who's speaking, who's making decisions, who's questioning things, and just kind of changing rules out. We often do that in some of our assessments that we do for teams, whether that be the Principles Us or the ELI 360s, just seeing how people interact and then you start to realize you have a, you have a way of showing up differently and just to try it is fun. And so she really talks about how changing slight things can make a big difference.

Gillian: And just gaining awareness is huge. We know as coaches that when our clients gain more awareness around who they are, who they're showing up as, and more awareness around who's on their team, it really helps the dynamics.

Lillian Liang Emlet: What do you think is the hardest part for leaders when they're trying to make these shifts and be different, be a better leader, coach kind of person? Where do they get stuck?

Gillian: I am going to go back to the awareness. So it's figuring out what it is that needs to change and new habits can be hard to make sustainable sometimes. So, I think trying out the new habit, the new behavior, and seeing that it works, getting some positive feedback or some positive responses will help a leader continue to try new things.

Lillian Liang Emlet: I hear what you're saying. That meaning that if they don't see any positive effect, they sort of stop doing and they go back to their old habits where they just try to fix things for everybody or have all the answers themselves and it's helpful to look for either some kind of support or positive response from their team to be able to keep doing those things.

Gillian: Right. And again, asking for feedback, we sometimes forget to do that as leaders, but it's very, very important. Sometimes we're scared of what might be coming at us, but just having that open door policy and being able to listen, to really hear what's going on, I think is very important.

Lillian Liang Emlet: I mean, listening rounds have been well documented in terms of being really important for all levels of leadership to go down into different areas, to be able to see what really happens. If you want to become that leader, the one who changes their team, one person in one interaction at a time. What do you think is the very first micro step that someone listening to this podcast could try tomorrow?

Gillian: I think, really pausing and really maybe taking more notice of... we all get into such,we get in the weeds, with the work that has to be done and whatever we're dealing with. , So possibly taking a step back and pausing and really considering who we have on the team and maybe there are other attributes that we're not using that we're not capitalizing on. And sometimes asking people what else would they like to achieve? What would help make their career more fulfilling? What career developmental goals would they like to achieve? And I think if there's that understanding, it can be very helpful as well.

Lillian Liang Emlet: I love those two main action points. So for leaders, can you do the step back? Can you just, you know, in the moment when you really want to get sucked into like some kind of problem, take a step back and then putting it back on the persons who are involved deeply in the frontline solutions, like what will help, like what structural supports give. Let them have some agency to suggest the ideas, because if you don't provide that opportunity to get the ideas and you just think you need to boss people around and tell people the outcome before it's even happened, you're actually closing off to innovation and closing off to letting people just do their job well, kind of thing. Yeah. So it's been really fun talking with you about all of these different teams. And so if this conversation is resonating with you, we'd love to invite you to share with a colleague or someone who, you know, might be, you know, thinking about their team dynamics right now or just entering into a new position in terms of leadership position and, as a healthcare leader, if you're ready to develop your skills, we'd love to begin the conversation about some of the programs we have here at Transforming Healthcare Coaching for you to become the leader to transform your team, one conversation at a time. We'd love to talk with you about working together. Head over to transforminghealthcarecoaching.com to learn about our leadership coaching programs. So, Gillian, I guess as we close out, do you have any final thoughts?

Gillian: We all know we have to listen, right? But we have to listen really carefully and take on what people are saying. Just being able to create the atmosphere, the climate for your teams where people feel safe coming to talk to you, and bringing things that may be of importance, like you were saying. Especially when it comes to patient safety, being feeling like they can come to talk without any fear of retribution or anything like that, so.

Lillian Liang Emlet: Love that. Thank you so much. Thanks everyone for listening, and we'll see you in our next episode.