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

Abstract

Introduction: Joint Commission predicted that 80 % of the serious safety events occur due to miscommunications among healthcare professionals. Speaking up is one of the critical behaviors of patient safety that displays an important role for improving quality and patient safety in healthcare. Objectives of this study are 'assessing the effectiveness of speaking up for patient safety', 'identifying the influencing factors of speaking up', 'evaluating the effectiveness of speaking up training' and 'finding enablers of speaking up'.Methods: This study was done to identify literature about 'speaking up' behaviors to improve safety outcomes via considering both patient and provider perspectives. Varied databases were used to find English articles that relevant to both patient and provider's speaking up behaviors that mainly focused to demonstrate its impact on patient safety outcomes. Data was extracted and analyzed to find influencing factors and recommended voicing up behaviors that display important role for improvement in quality and safety of healthcare. Results: 53 relevant articles were identified in 83 articles. Those 53 articles consist of 4 literature reviews, 3 RCTs, 8 cohorts, 1 case control, 34 cross sectional studies and 3 reports. This study is the first study about not just identifying factors that influencing speaking up behaviors among providers but also including factors of patients' voicing up behaviors for safety. This study is also providing some 'enablers of speaking up behaviors' which may help healthcare leaders and professionals' decision making process for quality and safety improvements in their organization. Conclusions: Speaking up is one of the critical behaviors of patient safety. Awareness of factors that 'influencing' and 'enabling' speaking up behaviors may help leaders and decision makers to improve quality and safety of healthcare in their organization. This study is providing complex process of speaking up behavior and their impacts on patient safety outcomes.

An integrative review exploring the perceptions of patients and healthcare professionals towards patient involvement in promoting hand hygiene compliance in the hospital setting

“…The literature review supports the findings of Nacioglu's () systematic review which concluded that enabling patients to speak up was critical to improve quality and safety in health care. This indicates that, although this strategy can be challenging to both patients and staff, it is one that should be explored further.…”

“…Patient involvement in hand hygiene might be appropriate when patients notice that HCPs do not wash or sanitise their hands before touching them, but may not feel able or encouraged to speak up to improve the quality and safety of their healthcare (Nacioglu, ). The concept of asking patients to remind HCPs to wash their hands may seem simple enough (Davis et al., ); however, patient involvement in this process is a new, and there is little evidence to suggest it happens in practice (Ridley & Jones, ) or indeed whether it is acceptable to both patients and HCPs.…”

Quality metrics for the evaluation of Rapid Response Systems: Proceedings from the third international consensus conference on Rapid Response Systems

“…In a broader context we found evidence that organisational culture influences staff experience and the ability to speak up. 67,68 and importantly can be influenced by Rapid Response Systems. 69 Despite the awareness of cultural differences in countries deploying RRSs we do wish to ICU length of stay is a well-recognized outcome measure that is routinely collected by many national data registries.…”

Patient Safety Culture in Perspective of Millennials: Case Study in a Malaysian Private Hospital

“…I have faced problems for bringing up issues beyond my manager." (NUR 17) There is a positive relationship between speaking up and patient safety (Nacioglu, 2016). However, difficulty with this is a contributing factor with errors and adverse events (Okuyama, Wagner, & Bijnen, 2014).…”