Research insights · Conversations & trust
A place to begin
Nembhard and Edmondson analyzed survey data from 23 neonatal intensive care units involved in improvement projects. Leader inclusiveness—words and actions inviting and appreciating contributions—was associated with psychological safety and examined in relation to professional-status differences.
Look at the invitation and the response together
The paper defines inclusiveness through words and actions that invite and appreciate contributions. That offers a way to look beyond a general statement that everyone is welcome to speak and toward what happens when they actually contribute.
After saying, “Please speak freely,” did your own explanation occupy most of the time? When someone offered an unfamiliar perspective, was the information considered? Put the intended invitation alongside the actual sequence of the exchange.
Equal speaking opportunities may hold unequal experiences
Giving everyone the same time does not tell you whether speaking feels equally demanding. A newcomer, a colleague from another function or someone with different expertise may be considering things you have not noticed. Distinguish your assumptions from what you have actually heard.
Before calling publicly on a quieter colleague, ask which way of participating would be workable. Advance questions or time to write may be options to choose together. Avoid treating the person’s preference as something you already understand.
Try naming something you do not yet know
Choose an agenda item involving another area of expertise. Name a specific uncertainty and ask someone who understands that area what you may be missing. You are broadening the information for a decision while retaining the responsibilities of your role.
Afterward, identify what was useful in their contribution. If you cannot adopt it immediately, explain what needs review and when you will respond. Ask whether the contributor can see what happened to the information they offered.
Hear the responsibilities behind cross-team differences
Before explaining your request, ask what the other department needs to protect and what constraints it faces. Notice the meaning you attached to a slow response. How does your request enter their existing work, and what do they need from you?
Once there is a shared outcome, make the action and timing specific. If a handoff problem keeps returning, explore decision authority, information and deadlines as well as the relationship. Goodwill need not carry an unclear operating agreement indefinitely.
What HR can ask about who is being heard
Avoid making one person explain the experience of an entire group or level. Hear common patterns through more than one route and explore whether useful information is missing from meetings and decisions. Look for participation paths that do not force disclosure or performance.
This week, name one uncertainty and invite another perspective on one decision. Reflect on new information, your first response and whether the person could see the later process. Use that small scene to choose what you would like to try next.
Connecting the research with coaching
A reflective application is to ask whose information is actually heard, beyond whether everyone can attend a meeting. The questions below translate a healthcare-team perspective into an inquiry about your own setting.
What to keep in view
This survey research concerns professional status and improvement work in healthcare. It does not establish identical effects in other industries or show that one inclusive sentence causes a performance outcome.
Original research and source
Ingrid M. Nembhard & Amy C. Edmondson (2006). Making it safe: The effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams.
Read the primary research record ↗Questions about this topic
Does inclusive leadership mean adopting every suggestion?
No. You can invite and appreciate input while making decision criteria clear. How a contribution is treated is distinct from whether it is adopted.
Can healthcare research be applied in other organizations?
Use it to investigate your own status and role differences without assuming identical outcomes.
Should I put a quiet colleague on the spot?
First explore a workable participation format, such as advance questions or a written contribution, rather than assuming public speaking is helpful.

