Interpersonal communication, as a central form of social resource derived from social relations, is crucial for individuals coping with threats in the workplace, especially for hospitals that provide high-quality care and patient safety. Using social system mentalization as a theoretical background, we applied psychosocial processes and a psychodynamic system approach to get insights on how healthcare workers interact with team members and patients. The goal was to test the following hypotheses: H1: Better communication is associated with fewer patient safety threats (H1a) and higher-quality care (H1b). H2: The associations between communication and patient safety threats (H2a) and higher-quality care (H2b) are mediated by psychological safety. In this two-studies design, we conducted a cross-sectional hospital survey (N= 129) and a survey of obstetric team members (N= 138) in Germany. Simple mediation analyses were run. Results revealed that communication is associated with safety performance. Further, the mediating effect of psychological safety between communication and safety performance was demonstrated. These findings contribute to an understanding of social relation representations, as individuals’ communication interrelates with safety performance mediated by psychological safety to complement healthcare and public health strategies. With a better understanding of communication and psychological safety, tools, routines, and concrete trainings can be designed.