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

Montgomery, Anthony; Lainidi, Olga

doi:10.3389/fpsyt.2022.818393

Cited by 9 publications

(7 citation statements)

References 60 publications

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“…Nurses who were too busy and suffering from burnout did not speak up [ 29 ]. An association between burnout and withholding voices among healthcare workers was previously observed [ 30 ]. Long working hours and high workloads caused mental and physical fatigue in healthcare workers, consequently reducing their ability to recognize safety concerns and speak up.…”

Section: Discussionmentioning

confidence: 93%

What inhibits “speaking up” for patient safety among healthcare workers? A cross-sectional study in Malaysia

Kim,

Nishino,

Bujang

et al. 2024

Hum Resour Health

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Background In healthcare, “speaking up” refers to when healthcare workers raise concerns regarding patient safety through questions, sharing information, or expressing their opinion to prevent harmful incidents and ensure patient safety. Conversely, withholding voice is an act of not raising concerns, which could be beneficial in certain situations. Factors associated with speaking up and withholding voices are not fully understood, especially in strong authoritarian societies, such as Malaysia. This study aimed to examine the factors associated with speaking up and withholding the voices of healthcare workers in Malaysia, thus providing suggestions that can be used in other countries facing similar patient safety challenges. Methods This cross-sectional study was conducted in a tertiary hospital in Sarawak State, Malaysia. Data were collected from 474 healthcare workers from 43 departments using a self-administered questionnaire for speaking up and withholding voices measures in 4 weeks prior to data analysis as well as socio-demographic factors of healthcare workers (sex, age group, profession, department, weekly work hours for patient care, years of employment in the hospital, and the hierarchical level) and speaking up related climate of the working environment were recorded. Data were analyzed using descriptive statistics. Logistic regression was performed to find out (adjusted) odds ratio of frequent speaking up and withholding voices. Results Nurse compared to doctors and healthcare workers with short weekly working hours were more likely to speak up. Healthcare workers in emergency and intensive care department, those with short years of employment, and those who worked at low hierarchical levels were less likely to speak up. Healthcare workers in discouraging environment towards speaking up were more likely to withhold their voices. Conclusions This study demonstrates the characteristics of healthcare workers who speak up and those who withhold their voices in Malaysia. To ensure patient safety and prevent harm, it is essential to establish an encouraging environment that promotes speaking up and prevents withholding voices among healthcare worker, especially in circumstances where multiple types of healthcare workers with different socio-demographic backgrounds work together.

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Section: Discussionmentioning

confidence: 93%

What inhibits “speaking up” for patient safety among healthcare workers? A cross-sectional study in Malaysia

Kim,

Nishino,

Bujang

et al. 2024

Hum Resour Health

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“…Chen et al ( 27 ) Emphasized That Employee Silence Has Negative Effects on Organizations. Montgomery and Lainidi ( 28 ) in Their Study, Associated Employee Silence That Occurs in Health Services With Hiding Mistakes, Reducing Patient Safety and Covering up Mistakes Made by Others. Yang et al ( 29 ), in Their Study With Nurses, It Was Suggested That Organizational Silence Represents an Important Problem for Health Institutions.…”

Section: Literature Reviewmentioning

confidence: 98%

The effect of perceived stress on organizational silence in emergency service doctors in Turkey: The mediating role of emotional intelligence

ERDOĞAN

Bayraktar

Uçan

et al. 2022

Front. Public Health

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ObjectivesThe purpose of this study is to determine the role of emotional intelligence in the relationship between the stress perceptions of emergency medicine doctors and their organizational silence behaviors.MethodsData were collected digitally from 434 doctors working in emergency departments in Turkey. On the assumption that perceived stress was effective on organizational silence behavior and that emotional intelligence mediates this relationship, hypotheses were developed and a mediating effect model was established. The research model and hypotheses were shaped through Structural Equation Modeling (SEM). Hayes 4th model was used to test the research hypotheses. The research model was tested via SPSS Process v4.1 by Andrew F. Hayes.ResultsAccording to the correlation analysis to determine the relationship between the variables, it was determined that perceived stress was positively correlated with organizational silence behavior, emotional intelligence was negatively correlated with perceived stress, and emotional intelligence was negatively correlated with organizational silence. As a result of the mediating effect model test, it was determined that emotional intelligence had a statistically significant mediating effect in the effect of perceived stress on organizational silence.ConclusionWithin the framework of the findings, it is thought that emotional intelligence is a key variable in turning the negative energy between stress and silence into positive.

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“…Stress increases the likelihood of formal silence. There is significant evidence that healthcare education is building a culture of performance first, where individual well-being and asking difficult questions are far down the list of priorities [ 24 ]. A ‘performance-first’ culture does not encourage speaking up.…”

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

Cited by 9 publications

References 60 publications

What inhibits “speaking up” for patient safety among healthcare workers? A cross-sectional study in Malaysia

What inhibits “speaking up” for patient safety among healthcare workers? A cross-sectional study in Malaysia

The effect of perceived stress on organizational silence in emergency service doctors in Turkey: The mediating role of emotional intelligence

Why Talking Is Not Cheap: Adverse Events and Informal Communication

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