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[When silence is dangerous: "Speaking-up" about safety concerns]
1Swiss Patient Safety Foundation, Zurich, Switzerland; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Summary
Healthcare professionals (HCPs) in German hospitals frequently experience patient safety concerns but often withhold communication. Interventions are needed to foster a culture of speaking up and improve patient safety.
Area of Science:
- Healthcare Management
- Patient Safety
- Organizational Behavior
Background:
- Open communication about errors and risks is crucial for patient safety and a strong safety culture in hospitals.
- Limited research exists on speaking-up behaviors among healthcare professionals (HCPs) in German-speaking countries.
- Understanding these behaviors is essential for improving patient care and reducing harm.
Purpose of the Study:
- To assess the prevalence of safety concerns and speaking-up behaviors among hospital staff in oncological units.
- To identify predictors of speaking-up, including hierarchical position.
- To understand the challenges HCPs face when communicating safety issues.
Main Methods:
- A self-administered survey was used to collect data from 1,013 physicians and nurses across nine oncological units in eight hospitals.
- The survey included a vignette to evaluate hypothetical speaking-up scenarios and their determinants.
- Statistical analysis investigated the association between hierarchical position and speaking-up behavior.
Main Results:
- Over half of HCPs (53%) reported frequent patient safety concerns.
- 30% observed colleagues bypassing safety rules, and nearly 20% admitted withholding safety information.
- Higher-ranking staff (73%) were more likely to report not withholding information compared to lower-ranking staff (60%), though speaking up was often perceived as difficult.
Conclusions:
- Healthcare professionals in hospitals frequently encounter and suppress safety concerns, representing a loss of valuable patient safety resources.
- A significant gap exists in speaking-up behaviors, even in critical situations like hand hygiene breaches.
- Developing targeted interventions to enhance the speaking-up culture is essential for improving patient safety in healthcare settings.
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