A ‘living intervention’: Evaluating a real-time feedback system to help teams co-create psychosocial safety climate

• Real-time monitoring provides new insight into how we measure Psychosocial Safety Climate. • Our app could be a cost-effective living intervention system for signalling psychosocial risk. • Climate is not a monolith; rather PSC is both stable and responsive to short-term fluctuations. • Managers have an opportunity for timely action on psychosocial safety signals. • Our evidence supports trending PSC theories such as PSC emergence and action potential. Psychosocial Safety Climate (PSC) is a leading indicator of safety issues, and Real-time monitoring (RTM) interventions offer the opportunity to address safety concerns for worker psychological health before problems compound. We pilot a new intervention that combines RTM of PSC, enabling teams to engage in a co-creation process to develop ownership over their ‘living intervention’. We ran the PSC-RTM system in N = 3 healthcare teams in a large metropolitan government hospital in Australia. Pre-intervention PSC training was followed by 10 weeks of a 24/7 app kiosk that provided continual feedback to guide team discussion of psychosocial safety. Results demonstrated that the PSC-RTM system could capture clear safety signals, and our data provides evidence of a PSC emergence process. There was also support for a PSC action potential effect whereby improvement in PSC only occurred for teams that met a threshold for change. Findings show that PSC is fluid not monolithic; it’s dynamic and responsive to immediate changes in the safety environment, with real-time safety signals followed by ‘recovery’ phases to a set point indicating evidence for a “PSC Pulse”. The PSC-RTM poses a potentially cost-effective system for organisations to monitor psychosocial risk before hazards arise. Our findings also provide new evidence on trending topics such as PSC emergence, PSC set point, the nature of safety signals, forms of PSC enactment, and how real-time monitoring systems play a role in feedback-seeking and feedback-sharing behaviours to improve safety. Therefore, future studies might consider going beyond measuring a ‘snapshot’ of PSC, but rather monitor a team’s PSC Pulse.