Interprofessional model on speaking up behaviour in healthcare professionals: a qualitative study

Area of Science:

• Healthcare Quality and Safety
• Medical Education
• Organizational Behavior in Medicine

Background:

• Healthcare professionals' reluctance to report patient safety concerns persists despite awareness of its importance.
• Speaking up is crucial for mitigating patient harm and improving healthcare outcomes.

Purpose of the Study:

• To identify barriers and facilitators influencing healthcare professionals' speaking up behaviors regarding patient safety.
• To inform the development of targeted interventions aimed at increasing the reporting of patient safety concerns.

Main Methods:

• Qualitative study involving focus groups and interviews with 62 nurses, advanced practice providers, and physicians.
• Data collected from October 2017 to February 2018 at three tertiary academic healthcare facilities.
• Participants shared personal experiences and perspectives on speaking up about patient safety.

Main Results:

• A predominantly hierarchical medical culture emerged as a significant barrier to speaking up.
• Institutional, interpersonal, and individual factors were found to influence the impact of hierarchical culture on speaking up.
• Strategies for communicating safety concerns were discussed by participants.

Conclusions:

• Training should extend beyond front-line staff to include institutional leaders and systems.
• Actively promoting and rewarding speaking up behaviors is essential for fostering a safer healthcare environment.
• Addressing the hierarchical culture is key to enhancing patient safety communication.