How Perceptions and Emotions Shaped Employee Silence in the Case of “Dr. Death” at Bundaberg Hospital

Edwards, Marissa S.; Lawrence, Steve; Ashkanasy, Neal M.

doi:10.1108/s1746-979120160000012015

Cited by 6 publications

(16 citation statements)

References 44 publications

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“…Inquiries into the Bristol Royal Infirmary Pediatric Scandal, the serial killer Dr. Harold Shipman, and the Mid-Staffordshire NHS Foundation Trust have all confirmed that whistleblowers played a crucial and constructive part in the identification of poor patient care that led to death and patient harm. The inquiry in the case of Dr. Jayant Patel, a surgeon at Bundaberg Hospital, Australia (Edwards et al, 2016), provides us with specific insight on how employees responded to failings in patient care over time. The role of whistleblowing here was crucial, but an analysis of the events that led to the inquiry shows, at the level of informal communication, employees were unofficially discussing their concerns during the period of sensemaking, which led to either silence or formal reporting or whistleblowing (Edwards et al, 2016).…”

Section: Why Is Understanding Employee Silence Important In Health Care?mentioning

confidence: 99%

“…The inquiry in the case of Dr. Jayant Patel, a surgeon at Bundaberg Hospital, Australia (Edwards et al, 2016), provides us with specific insight on how employees responded to failings in patient care over time. The role of whistleblowing here was crucial, but an analysis of the events that led to the inquiry shows, at the level of informal communication, employees were unofficially discussing their concerns during the period of sensemaking, which led to either silence or formal reporting or whistleblowing (Edwards et al, 2016). When adverse events started occurring, employees engaged in discussions regarding Dr. Patel’s behaviors, performance, and decisions among themselves.…”

Section: Why Is Understanding Employee Silence Important In Health Care?mentioning

confidence: 99%

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Employee silence in health care: Charting new avenues for leadership and management

Montgomery

Lainidi

Johnson

et al. 2022

Health Care Manage Rev

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IssueHealth care management is faced with a basic conundrum about organizational behavior; why do professionals who are highly dedicated to their work choose to remain silent on critical issues that they recognize as being professionally and organizationally significant? Speaking-up interventions in health care achieve disappointing outcomes because of a professional and organizational culture that is not supportive.Critical Theoretical AnalysisOur understanding of the different types of employee silence is in its infancy, and more ethnographic and qualitative work is needed to reveal the complex nature of silence in health care. We use the sensemaking theory to elucidate how the difficulties to overcoming silence in health care are interwoven in health care culture.Insight/AdvanceThe relationship between withholding information and patient safety is complex, highlighting the need for differentiated conceptualizations of silence in health care. We present three Critical Challenge points to advance our understanding of silence and its roots by (1) challenging the predominance of psychological safety, (2) explaining how we operationalize sensemaking, and (3) transforming the role of clinical leaders as sensemakers who can recognize and reshape employee silence. These challenges also point to how employee silence can also result in a form of dysfunctional professionalism that supports maladaptive health care structures in practice.Practice ImplicationsDelineating the contextual factors that prompt employee silence and encourage speaking up among health care workers is crucial to addressing this issue in health care organizations. For clinical leaders, the challenge is to valorize behaviors that enhance adaptive and deep psychological safety among teams and within professions while modeling the sharing of information that leads to improvements in patient safety and quality of care.

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Section: Why Is Understanding Employee Silence Important In Health Care?mentioning

confidence: 99%

Section: Why Is Understanding Employee Silence Important In Health Care?mentioning

confidence: 99%

Employee silence in health care: Charting new avenues for leadership and management

Montgomery

Lainidi

Johnson

et al. 2022

Health Care Manage Rev

View full text Add to dashboard Cite

show abstract

“…The inquiry in the case of Dr. Jayant Patel at Bundaberg Hospital, Australia [ 32 ] can also provide insight into how employees responded to failings in patient care over time. Once again, the role of whistleblowing here was crucial.…”

Section: Adverse Events (Aes) and Informal Communicationmentioning

confidence: 99%

Why Talking Is Not Cheap: Adverse Events and Informal Communication

Montgomery,

Lainidi,

Georganta

2024

Healthcare

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Healthcare management faces significant challenges related to upward communication. Sharing information in healthcare is crucial to the improvement of person-centered, safe, and effective patient care. An adverse event (AE) is an unintended or unexpected incident that causes harm to a patient and may lead to temporary or permanent disability. Learning from adverse events in healthcare is crucial to the improvement of patient safety and quality of care. Informal communication channels represent an untapped resource with regard to gathering data about the development of AEs. In this viewpoint paper, we start by identifying how informal communication played a key factor in some high-profile adverse events. Then, we present three Critical Challenge points that examine the role of informal communication in adverse events by (1) understanding how the prevailing trends in healthcare will make informal communication more important, (2) explaining how informal communication is part of the group-level sensemaking process, and (3) highlighting the potential role of informal communication in “breaking the silence” around critical and adverse events. Gossip, as one of the most important sources of informal communication, was examined in depth. Delineating the role of informal communication and adverse events within the healthcare context is pivotal to understanding and improving team and upward communication in healthcare organizations. For clinical leaders, the challenge is to cultivate a climate of communication safety, whereby informal communication channels can be used to collect soft intelligence that are paths to improving the quality of care and patient safety.

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“…For example, in the paper of Edwards et al a step-by-step analysis of the case of “Dr. Death” at the Bundaberg Hospital in Australia revealed that numerous allegations of harassment and bullying were filed prior to the official inquiry starting ( 49 ). The inquiry concluded that 13 patients died due to negligence, and highlighted how harassment and bullying behaviors were used to intimidate junior staff into silence.…”

Section: How Is Silence Maintained Post Residency?mentioning

confidence: 99%

Understanding the Link Between Burnout and Sub-Optimal Care: Why Should Healthcare Education Be Interested in Employee Silence?

Montgomery

Lainidi

2022

Front. Psychiatry

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Evidence on the association of burnout with objective indicators of performance is scarce in healthcare. In parallel, healthcare professionals ameliorate the short-term impact of burnout by prioritizing some tasks over others. The phenomenon of employee silence can help us understand the evolution of how culture is molded toward the prioritization of some tasks over others, and how this contributes to burnout. Silence in healthcare has been associated with concealing errors, reduced patient safety, and covering up errors made by others. Conversely, there is evidence that in organizations where employees are encouraged to speak up about concerns, and where concerns are responded to appropriately, better patient outcomes such as improved patient safety and patient experience occur. Interventions to promote “speaking-up” in healthcare have not been successful and are rooted in a professional culture that does not promote speaking out. In this paper, we review the evidence that exists within healthcare to argue why healthcare education should be interested in employee silence, and how silence is a key factor in understanding how burnout develops and impacts quality of care. The following key questions have been addressed; how employee silence evolves during medical education, how is silence maintained after graduation, and how can leadership style contribute to silence in healthcare. The impact of withholding information on healthcare professional burnout, patient safety and quality of care is significant. The paper concludes with a suggested future research agenda and additional recommendations.

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How Perceptions and Emotions Shaped Employee Silence in the Case of “Dr. Death” at Bundaberg Hospital

Cited by 6 publications

References 44 publications

Employee silence in health care: Charting new avenues for leadership and management

Employee silence in health care: Charting new avenues for leadership and management

Why Talking Is Not Cheap: Adverse Events and Informal Communication

Understanding the Link Between Burnout and Sub-Optimal Care: Why Should Healthcare Education Be Interested in Employee Silence?

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