Jason M Etchegaray1, Madelene J Ottosen2, Theresa Dancsak3, Eric J Thomas2. 1. From the RAND Corporation, Santa Monica, California. 2. The University of Texas Medical School at Houston and The University of Texas at Houston-Memorial Hermann Center for Healthcare Quality and Safety. 3. Clinical Research Unit at the Center for Clinical and Translational Research, Memorial Hermann, Houston, Texas.
Abstract
OBJECTIVES: We sought to examine the association between willingness of health-care professionals to speak up about patient safety concerns and their perceptions of two types of organizational culture (ie, safety and teamwork) and understand whether nursing professionals and other health-care professionals reported the same barriers to speaking up about patient safety concerns. METHODS: As part of an annual safety culture survey in a large health-care system, we asked health-care professionals to tell us about the main barriers that prevent them from speaking up about patient safety concerns. Approximately 1341 respondents completed the anonymous, electronic survey. RESULTS: A little more than half (55%) of the participants mentioned leadership (fear of no change or retaliation) and personal (ie, fear of negative feedback or being wrong) barriers concerning why they would not speak up about patient safety concerns. The remaining participants (45%) indicated they would always speak up. These findings about barriers were consistent across nurses and other health-care professionals. Safety culture (SC) and teamwork culture (TC) scores were significantly more positive in those indicating they would always speak up (SC = 89%, TC = 89%) than in those who provided reasons for not speaking up (SC = 63%, TC = 64%) (t1205 = 13.99, P < 0.05, and t1217 = 13.61, P < 0.05, respectively). CONCLUSIONS: Health-care professionals emphasized leadership and personal barriers as reasons for not speaking up. We also demonstrated an association between not speaking up and lower safety and teamwork culture scores.
OBJECTIVES: We sought to examine the association between willingness of health-care professionals to speak up about patient safety concerns and their perceptions of two types of organizational culture (ie, safety and teamwork) and understand whether nursing professionals and other health-care professionals reported the same barriers to speaking up about patient safety concerns. METHODS: As part of an annual safety culture survey in a large health-care system, we asked health-care professionals to tell us about the main barriers that prevent them from speaking up about patient safety concerns. Approximately 1341 respondents completed the anonymous, electronic survey. RESULTS: A little more than half (55%) of the participants mentioned leadership (fear of no change or retaliation) and personal (ie, fear of negative feedback or being wrong) barriers concerning why they would not speak up about patient safety concerns. The remaining participants (45%) indicated they would always speak up. These findings about barriers were consistent across nurses and other health-care professionals. Safety culture (SC) and teamwork culture (TC) scores were significantly more positive in those indicating they would always speak up (SC = 89%, TC = 89%) than in those who provided reasons for not speaking up (SC = 63%, TC = 64%) (t1205 = 13.99, P < 0.05, and t1217 = 13.61, P < 0.05, respectively). CONCLUSIONS: Health-care professionals emphasized leadership and personal barriers as reasons for not speaking up. We also demonstrated an association between not speaking up and lower safety and teamwork culture scores.
Authors: Fabio Walther; Carl Schick; David Schwappach; Evgeniya Kornilov; Sharon Orbach-Zinger; Daniel Katz; Michael Heesen Journal: J Patient Saf Date: 2022-09-08 Impact factor: 2.243