Treating an unhealthy organisational culture: the implications of the Bundaberg Hospital Inquiry for managerial ethical decision making

Casali, Gian Luca; Day, Gary

doi:10.1071/ah09543

Cited by 25 publications

(30 citation statements)

References 7 publications

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“…1 The nature of an organization is based on its ethical values, which can highly affect the success of the organization if they are taken into account when members make decisions. 2…”

Section: Introductionmentioning

confidence: 99%

Sensitivity in ethical decision-making: The experiences of nurse managers

2019

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Background: In order to achieve the goals of the healthcare system, nursing managers are required to comply with ethical principles in decision-making. In complex and challenging healthcare settings, it is shown that the managers’ mere awareness of ethics does not suffice and managers need to be sensitive toward making ethical decisions. Aim: To explore nursing managers and their sensitivity toward ethical decision-making by analyzing their related experiences. Method: The current study has been conducted in Iran in 2017 through a qualitative content analysis approach. Nineteen nurse managers were selected purposefully from different hospitals in Tehran. Data were collected using semi-structured, in-depth, face-to-face interviews, and after transcription, they were analyzed according to the Graneheim and Lundman method. Ethical considerations: The research was approved by the ethics committee of Tarbiat Modares University, Tehran, Iran. Participants were informed about the purpose of the study and submitted written informed consents regarding their participation. The principle of autonomy, confidentiality, and anonymity was taken into account in data collection. Results: Fifteen subcategories, three categories (assertiveness, commitment, and insight), and one theme of excellent decision-making were the results of data analysis. Discussion: Findings showed that nursing managers’ sensitivity to ethical decision-making allows them to make the best decision by insight, commitment, and assertiveness. Making a morally excellent decision ensures that ethical principles are followed in the healthcare system. Conclusion: Considering that most managers are committed to making ethical decisions, it is required to develop the scope of their insights even further using a professional management and ethical principles training program. Also, by addressing some of the ethical barriers at personal and organizational levels, the assertiveness in managers can be improved, which in turn can facilitate their ethical decision-making.

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“…1 The nature of an organization is based on its ethical values, which can highly affect the success of the organization if they are taken into account when members make decisions. 2…”

Section: Introductionmentioning

confidence: 99%

Sensitivity in ethical decision-making: The experiences of nurse managers

2019

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“…Calls have been made for greater openness within the National Health Service (NHS) in England, with the intention of creating of a culture ‘ where mistakes are acknowledged and learned from’ [ 1 ], thus attempting to counteract the effects of past failings that have come to public attention in recent years [ 2 , 3 ]. Elsewhere in the world, policy makers have similarly identified issues with openness about the quality of care, ranging from day-to-day shortcomings in reviewing and learning from incidents [ 4 ], to major scandals involving persistent failures and efforts to conceal them [ 5 ]. Greater openness and transparency about such issues, among healthcare staff and between staff and their patients, is often suggested as a means of addressing these issues and improving the quality of care [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Openness in the NHS: a secondary longitudinal analysis of national staff and patient surveys

McCarthy

Dawson

Martin

2020

BMC Health Serv Res

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Background Improving openness—including candour when things go wrong, and willingness to learn from mistakes—is increasingly seen as a priority in many healthcare systems. This study explores perceptions of openness in England before and after the publication of the Francis report (2013), which examined failings of openness at one English hospital. We examine whether staff and patients’ views on openness, and experiences of giving voice to concerns, have changed since the report’s publication for better or worse. Methods Organisational-level data was collated for all trusts from the NHS National Staff Survey (2007–2017), NHS Acute Inpatient Survey (2004–2016) and NHS Community Mental Health Service User Survey (2007–2017). Survey items related to openness were identified and longitudinal statistical analysis conducted (piecewise growth curve and interrupted latent growth curve analysis) to determine whether there was evidence of a shift in the rate or direction of change following publication of the Francis report. Results For some variables there was a discernible change in trajectory after the publication of the Francis report. Staff survey variables continued to rise after 2013, with a statistically significant increase in rate for “fairness and effectiveness of incident reporting procedures” (from + 0.02 to + 0.06 per year; p < .001). For the patient surveys, the picture was more mixed: patient views about information provided by accident and emergency staff rose from a 0.3% increase per year before 2013 to 0.8% per year afterwards (p < .01), and inpatients being involved in decision making increased from a 0.4% rise per year before 2013 to 0.8% per year afterwards (p < .01); however, there were not rises in the other questions. Mental health patients reported a decrease after 2013 in being listened to (decreasing at a rate of 1.9% per year, p < .001). Conclusions Data suggest that the Francis inquiry may have had a positive impact on staff and acute inpatients’ perceptions and experiences of openness in the NHS. However such improvements have not transpired in mental health. How best to create an environment in which patients can discuss their care and raise concerns openly in mental health settings may require further consideration.

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“…In one of the earliest discussions of the "Dr. Death" case, Morton (2005) argued that a highly bureaucratic approach to healthcare focused on "corporate structures [that] devalue clinical involvement, alienate hospital communities, diminish humanity … and [concentrate] on business plans and targets" (p. 328) has contributed significantly to problems in the Australian healthcare system today. In a subsequent analysis of the culture and decisionmaking processes in place at Bundaberg Base Hospital during Dr. Patel's employment, Casali and Day (2010) noted that managers failed to exercise their duty of care to protect their staff and patients from harm. In particular, they noted that a disconnect existed between the organizational values held by staff and promoted to the wider public (e.g., integrity, honesty, open discussion of concerns) and those advocated by management.…”

Section: Organizational Contextmentioning

confidence: 99%

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

Edwards¹,

Lawrence²,

Ashkanasy³

2016

Emotions and Organizational Governance

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If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. ABSTRACTPurpose À For over three decades, researchers have sought to identify factors influencing employees' responses to wrongdoing in work settings, including organizational, contextual, and individual factors. In focusing predominantly on understanding whistle-blowing responses, however, researchers have tended to neglect inquiry into employees' decisions to withhold concerns. The major purpose of this study was to explore the factors that influenced how staff members responded to a series of adverse events in a healthcare setting in Australia, with a particular focus on the role of perceptions and emotions.Research limitations/implications À Although limited to publicly available transcripts only, our findings provide support for the idea that perceptions and emotions play important roles in shaping employees' responses to adverse events at work, and that decisions about whether to voice concerns about wrongdoing is an ongoing process, influenced by emotions, sensemaking, and critical events.

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Treating an unhealthy organisational culture: the implications of the Bundaberg Hospital Inquiry for managerial ethical decision making

Cited by 25 publications

References 7 publications

Sensitivity in ethical decision-making: The experiences of nurse managers

Sensitivity in ethical decision-making: The experiences of nurse managers

Openness in the NHS: a secondary longitudinal analysis of national staff and patient surveys

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

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