Lack of Trust in Healthcare Staff Threatens Patient Safety – Expert Warns

“Trust Deficit Is a Silent Killer in African Healthcare” – Dr. Debo Odulana

A critical lack of trust within African healthcare institutions is quietly undermining patient safety and staff effectiveness, warns Dr. Debo Odulana, Healthcare Management Consultant and CEO of Cedarcrest Hospital.

In an interview with the News Agency of Nigeria (NAN) on Saturday in Abuja, Dr. Odulana highlighted that fear-based workplace cultures are widespread across hospitals in Sub-Saharan Africa, stifling both communication and productivity.

Fear Culture Hampers Incident Reporting and Learning

“Hospitals continue to struggle with low incident reporting because staff fear blame rather than seeing mistakes as opportunities to learn,” Odulana stated.

He pointed to several systemic issues that contribute to this breakdown, including rigid hierarchies, disengaged employees, and micromanagement by leaders who lack confidence in their teams.

“Suppressed voices, where hierarchy stifles ideas, disengaged staff who do the bare minimum, and leaders who micromanage because they don’t trust their teams, are widespread challenges. This isn’t just a leadership issue. It is a patient safety crisis,” he said.

Psychological Safety: The Missing Infrastructure

Dr. Odulana emphasized the importance of psychological safety, calling it a foundational element for quality healthcare delivery on the continent.

“When staff are afraid to speak up, patients suffer. But imagine a different reality: a nurse spots a near-miss in surgery and reports it immediately without fearing punishment.

A young doctor proposes a new workflow, and leadership listens. A finance officer questions a procurement practice and, instead of being silenced, saves the hospital millions. That is what happens when trust is restored,” he explained.

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“Fear Is the Enemy of Learning” – Edmondson Quoted

Backing his views with insights from thought leaders, Odulana referenced Harvard professor Amy Edmondson’s research:

“Fear is the enemy of learning.”

He added that healthcare systems cannot be sustainably built on a foundation of silence and suppression.

“Better Is Possible” – Gawande’s Optimism Echoed

Quoting renowned surgeon and author Atul Gawande, Odulana reminded stakeholders of the moral imperative to improve:

“Better is possible. It does not take a genius. It takes diligence, moral clarity, ingenuity and above all, a willingness to try.”

Call to Action: Make Trust Central to Health Reforms

Dr. Odulana urged African governments and hospital administrators to make psychological safety a cornerstone of healthcare reform.

“When staff trust leadership, leadership trusts staff, patients trust providers, and financiers trust the system, the whole ecosystem shifts,” he noted.

Rebuilding Trust Is the Real Currency for Progress

While acknowledging the importance of infrastructure and funding, Odulana concluded that neither would be enough without trust at the core:

“Rebuilding trust within the health system is the real currency for achieving safer, more effective and world-class healthcare outcomes in Africa,” he said.