Limits...
Speaking up for patient safety by hospital-based health care professionals: a literature review.

Okuyama A, Wagner C, Bijnen B - BMC Health Serv Res (2014)

Bottom Line: Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns.This review focused on health care professionals' speaking-up behaviour for patient safety and aimed at (1) assessing the effectiveness of speaking up, (2) evaluating the effectiveness of speaking-up training, (3) identifying the factors influencing speaking-up behaviour, and (4) developing a model for speaking-up behaviour.Five databases (PubMed, MEDLINE, CINAHL, Web of Science, and the Cochrane Library) were searched for English articles describing health care professionals' speaking-up behaviour as well as those evaluating the relationship between speaking up and patient safety.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Total Health Promotion Science, School of Health Sciences, Graduate School of Medicine, Osaka University, Yamadaoka 1-7, Suita-shi 565-0871, Osaka, Japan. aokuyama-tky@umin.ac.jp.

ABSTRACT

Background: Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns. Understanding the influencing factors can help to improve speaking-up behaviour and team communication. This review focused on health care professionals' speaking-up behaviour for patient safety and aimed at (1) assessing the effectiveness of speaking up, (2) evaluating the effectiveness of speaking-up training, (3) identifying the factors influencing speaking-up behaviour, and (4) developing a model for speaking-up behaviour.

Methods: Five databases (PubMed, MEDLINE, CINAHL, Web of Science, and the Cochrane Library) were searched for English articles describing health care professionals' speaking-up behaviour as well as those evaluating the relationship between speaking up and patient safety. Influencing factors were identified and then integrated into a model of voicing behaviour.

Results: In total, 26 studies were identified in 27 articles. Some indicated that hesitancy to speak up can be an important contributing factor in communication errors and that training can improve speaking-up behaviour. Many influencing factors were found: (1) the motivation to speak up, such as the perceived risk for patients, and the ambiguity or clarity of the clinical situation; (2) contextual factors, such as hospital administrative support, interdisciplinary policy-making, team work and relationship between other team members, and attitude of leaders/superiors; (3) individual factors, such as job satisfaction, responsibility toward patients, responsibility as professionals, confidence based on experience, communication skills, and educational background; (4) the perceived efficacy of speaking up, such as lack of impact and personal control; (5) the perceived safety of speaking up, such as fear for the responses of others and conflict and concerns over appearing incompetent; and (6) tactics and targets, such as collecting facts, showing positive intent, and selecting the person who has spoken up.

Conclusions: Hesitancy to speak up can be an important contributing factor to communication errors. Our model helps us to understand how health care professionals think about voicing their concerns. Further research is required to investigate the relative importance of different factors.

Show MeSH

Related in: MedlinePlus

Model of health care professionals’ speaking up. Bold shows the framework of Morrison’s model of employee voice. Italic shows identified speaking-up factors
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4016383&req=5

Figure 2: Model of health care professionals’ speaking up. Bold shows the framework of Morrison’s model of employee voice. Italic shows identified speaking-up factors

Mentions: Previous studies have shown that many factors can have an effect on the speaking-up behaviour of health care professionals. These influencing factors could be assigned to the following categories: motivation and clinical context, general contextual factors, individual factors, the perceived safety of speaking up, and the perceived efficacy of speaking up (Figure 2).


Speaking up for patient safety by hospital-based health care professionals: a literature review.

Okuyama A, Wagner C, Bijnen B - BMC Health Serv Res (2014)

Model of health care professionals’ speaking up. Bold shows the framework of Morrison’s model of employee voice. Italic shows identified speaking-up factors
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016383&req=5

Figure 2: Model of health care professionals’ speaking up. Bold shows the framework of Morrison’s model of employee voice. Italic shows identified speaking-up factors
Mentions: Previous studies have shown that many factors can have an effect on the speaking-up behaviour of health care professionals. These influencing factors could be assigned to the following categories: motivation and clinical context, general contextual factors, individual factors, the perceived safety of speaking up, and the perceived efficacy of speaking up (Figure 2).

Bottom Line: Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns.This review focused on health care professionals' speaking-up behaviour for patient safety and aimed at (1) assessing the effectiveness of speaking up, (2) evaluating the effectiveness of speaking-up training, (3) identifying the factors influencing speaking-up behaviour, and (4) developing a model for speaking-up behaviour.Five databases (PubMed, MEDLINE, CINAHL, Web of Science, and the Cochrane Library) were searched for English articles describing health care professionals' speaking-up behaviour as well as those evaluating the relationship between speaking up and patient safety.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Total Health Promotion Science, School of Health Sciences, Graduate School of Medicine, Osaka University, Yamadaoka 1-7, Suita-shi 565-0871, Osaka, Japan. aokuyama-tky@umin.ac.jp.

ABSTRACT

Background: Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns. Understanding the influencing factors can help to improve speaking-up behaviour and team communication. This review focused on health care professionals' speaking-up behaviour for patient safety and aimed at (1) assessing the effectiveness of speaking up, (2) evaluating the effectiveness of speaking-up training, (3) identifying the factors influencing speaking-up behaviour, and (4) developing a model for speaking-up behaviour.

Methods: Five databases (PubMed, MEDLINE, CINAHL, Web of Science, and the Cochrane Library) were searched for English articles describing health care professionals' speaking-up behaviour as well as those evaluating the relationship between speaking up and patient safety. Influencing factors were identified and then integrated into a model of voicing behaviour.

Results: In total, 26 studies were identified in 27 articles. Some indicated that hesitancy to speak up can be an important contributing factor in communication errors and that training can improve speaking-up behaviour. Many influencing factors were found: (1) the motivation to speak up, such as the perceived risk for patients, and the ambiguity or clarity of the clinical situation; (2) contextual factors, such as hospital administrative support, interdisciplinary policy-making, team work and relationship between other team members, and attitude of leaders/superiors; (3) individual factors, such as job satisfaction, responsibility toward patients, responsibility as professionals, confidence based on experience, communication skills, and educational background; (4) the perceived efficacy of speaking up, such as lack of impact and personal control; (5) the perceived safety of speaking up, such as fear for the responses of others and conflict and concerns over appearing incompetent; and (6) tactics and targets, such as collecting facts, showing positive intent, and selecting the person who has spoken up.

Conclusions: Hesitancy to speak up can be an important contributing factor to communication errors. Our model helps us to understand how health care professionals think about voicing their concerns. Further research is required to investigate the relative importance of different factors.

Show MeSH
Related in: MedlinePlus