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Defining Speaking Up in the Healthcare System: a Systematic Review.

Julia Kane1, Lindsay Munn2, Shawn F Kane3

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Healthcare professionals need a clear definition of "speaking up" to improve patient safety. This study proposes a unified definition to address inconsistencies in current practice and research.

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Area of Science:

  • Healthcare communication
  • Patient safety research
  • Organizational behavior in healthcare

Background:

  • Communication failures are a significant source of medical errors.
  • The concept of "speaking up" lacks a consistent definition and operationalization in healthcare.
  • Existing definitions vary widely, hindering consistent application and research.

Approach:

  • Systematic literature review of multiple databases (PubMed, CINAHL, PsychoInfo, Communication/Mass Media Complete) from 1999-2020.
  • Inclusion criteria focused on articles defining or measuring "speaking up" for patient safety, excluding non-health-related uses.
  • Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Key Points:

  • 294 articles met inclusion criteria; 58 focused on speaking up.
  • "Speak up" and "raise concern" were common synonyms, but only 43 articles provided a definition.
  • A modified definition was developed: A healthcare professional identifying a patient safety concern and voicing it to an empowered individual.

Conclusions:

  • Speaking up is crucial for enhancing patient safety.
  • A lack of consensus on defining and measuring speaking up persists.
  • Reconceptualizing "speaking up" with a single, comprehensive definition is necessary for healthcare.