Speaking Up for Patient Safety: What They Don’t Tell You in Training About Feedback and Burnout

Patient safety is a key role for all staff who work in the perioperative environment. Being able to raise concerns and have these concerns listened to is a big part of maintaining patient safety. Freedom to Speak Up Guardians were introduced to assist health care workers in raising concerns; however, their access to perioperative areas may be restricted. This article therefore looks to explain the role of Freedom to Speak Up Guardians and how this new role impacts on how concerns should be raised.

Download Full-text

Conflict resolution in anaesthesia: systematic review

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2017-000264 ◽

2018 ◽

Vol 5 (1) ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Dalal Salem Almghairbi ◽

Takawira C Marufu ◽

Iain K Moppett

Keyword(s):

Patient Safety ◽

Conflict Resolution ◽

English Language ◽

Management Training ◽

Total Sample ◽

Cochrane Library ◽

Clinical Environment ◽

Speaking Up ◽

Study Results ◽

Training Programmes

BackgroundConflict is a significant and recurrent problem in most modern healthcare systems. Given its ubiquity, effective techniques to manage or resolve conflict safely are required.ObjectiveThis review focuses on conflict resolution interventions for improvement of patient safety through understanding and applying/teaching conflict resolution skills that critically depend on communication and improvement of staff members’ ability to voice their concerns.MethodsWe used the Population-Intervention-Comparator-Outcome model to outline our methodology. Relevant English language sources for both published and unpublished papers up to February 2018 were sourced across five electronic databases: the Cochrane Library, EMBASE, MEDLINE, SCOPUS and Web of Science.ResultsAfter removal of duplicates, 1485 studies were screened. Six articles met the inclusion criteria with a total sample size of 286 healthcare worker participants. Three training programmes were identified among the included studies: (A) crisis resource management training; (B) the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) training; and (C) the two-challenge rule (a component of TeamSTEPPS), and two studies manipulating wider team behaviours. Outcomes reported included participant reaction and observer rating of conflict resolution, speaking up or advocacy-inquiry behaviours. Study results were inconsistent in showing benefits of interventions.ConclusionThe evidence for training to improve conflict resolution in the clinical environment is sparse. Novel methods that seek to influence wider team behaviours may complement traditional interventions directed at individuals.

Download Full-text

Conflict, confusion and inconsistencies: Pre‐registration nursing students’ perceptions and experiences of speaking up for patient safety

Nursing Inquiry ◽

10.1111/nin.12381 ◽

2020 ◽

Author(s):

Anthea Fagan ◽

Jackie Lea ◽

Vicki Parker

Keyword(s):

Patient Safety ◽

Nursing Students ◽

Speaking Up

Download Full-text

As a critical behavior to improve quality and patient safety in health care: speaking up!

Safety in Health ◽

10.1186/s40886-016-0021-x ◽

2016 ◽

Vol 2 (1) ◽

Cited By ~ 7

Author(s):

Ahmet Nacioglu

Keyword(s):

Health Care ◽

Patient Safety ◽

Critical Behavior ◽

Improve Quality ◽

Speaking Up ◽

Quality And Patient Safety

Download Full-text

Speaking up about patient safety concerns: the influence of safety management approaches and climate on nurses’ willingness to speak up

BMJ Quality & Safety ◽

10.1136/bmjqs-2017-007163 ◽

2018 ◽

Vol 28 (1) ◽

pp. 39-48 ◽

Cited By ~ 17

Author(s):

Carien W Alingh ◽

Jeroen D H van Wijngaarden ◽

Karina van de Voorde ◽

Jaap Paauwe ◽

Robbert Huijsman

Keyword(s):

Patient Safety ◽

Safety Management ◽

Psychological Safety ◽

Regression Analyses ◽

Speaking Up ◽

Safety Concerns ◽

Management Approaches ◽

Nurses Perceptions ◽

Speak Up ◽

The Relationship

BackgroundSpeaking up is important for patient safety, but healthcare professionals often hesitate to voice their concerns. Direct supervisors have an important role in influencing speaking up. However, good insight into the relationship between managers’ behaviour and employees’ perceptions about whether speaking up is safe and worthwhile is still lacking.AimTo explore the relationships between control-based and commitment-based safety management, climate for safety, psychological safety and nurses’ willingness to speak up.MethodsWe conducted a cross-sectional survey study, resulting in a sample of 980 nurses and 93 nurse managers working in Dutch clinical hospital wards. To test our hypotheses, hierarchical regression analyses (at ward level) and multilevel regression analyses were conducted.ResultsSignificantly positive associations were found between nurses’ perceptions of control-based safety management and climate for safety (β=0.74; p<0.001), and between the perceived levels of commitment-based management and team psychological safety (β=0.36; p<0.01). Furthermore, team psychological safety is found to be positively related to nurses’ speaking up attitudes (B=0.24; t=2.04; p<0.05). The relationship between nurse-rated commitment-based safety management and nurses’ willingness to speak up is fully mediated by team psychological safety.ConclusionResults provide initial support that nurses who perceive higher levels of commitment-based safety management feel safer to take interpersonal risks and are more willing to speak up about patient safety concerns. Furthermore, nurses’ perceptions of control-based safety management are found to be positively related to a climate for safety, although no association was found with speaking up. Both control-based and commitment-based management approaches seem to be relevant for managing patient safety, but when it comes to encouraging speaking up, a commitment-based safety management approach seems to be most valuable.

Download Full-text