Interventions promoting employee “speaking-up” within healthcare workplaces: A systematic narrative review of the international literature
•Implementation of speak-up interventions are either effective, ineffective or indeterminate.•The development of speak-up interventions rarely consider and build-upon existing research findings.•Local speak-up interventions rarely consider and build-upon national or trans-national policy directives....
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| Vydané v: | Health policy (Amsterdam) Ročník 125; číslo 3; s. 375 - 384 |
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| Hlavní autori: | , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Ireland
Elsevier B.V
01.03.2021
Elsevier Science Ltd |
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| ISSN: | 0168-8510, 1872-6054, 1872-6054 |
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| Abstract | •Implementation of speak-up interventions are either effective, ineffective or indeterminate.•The development of speak-up interventions rarely consider and build-upon existing research findings.•Local speak-up interventions rarely consider and build-upon national or trans-national policy directives.•Speaking-up is shaped by socio-cultural norms and values existing out-with the organisation.
Healthcare systems worldwide increasingly value the contribution of employee voice in ensuring the quality of patient care. Although employees’ concerns are often dealt with satisfactorily, considerable evidence suggests that some employees may feel unable to speak-up, and even when they do their concerns may be ignored. As a result, in addition to trans-national and national policies, workplace interventions that support employees to speak-up about their concerns have recently increased.
A systematic narrative review, informed by complex systems perspectives addresses the question: “What workplace strategies and/or interventions have been implemented to promote speaking-up by employees”?
Thirty-four studies were included in the review. Most studies reported inconclusive results. Researchers explanations for the successful implementation, or otherwise, of speak-up interventions were synthesised into two narrative themes (Braithwaite et al., 2018 (a)) hierarchical, interdisciplinary and cultural relationships and (Francis, 2015 (b)) psychological safety.
We strengthen the existing evidence base by providing an in-depth critique of the complex system factors influencing the implementation of speak-up interventions within the healthcare workforce. Although many of the studies were locally unique, there were international similarities in workplace cultures and norms that created contexts inimical to speaking-up interventions. Changing communication behaviours and creating a climate that supports speaking-up is immensely challenging. Interventions can be usurped in practice by complex, emergent and contextual issues, such as pre-existing socio-cultural relationships and workplace hierarchies. |
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| AbstractList | Highlights•Implementation of speak-up interventions are either effective, ineffective or indeterminate. •The development of speak-up interventions rarely consider and build-upon existing research findings. •Local speak-up interventions rarely consider and build-upon national or trans-national policy directives. •Speaking-up is shaped by socio-cultural norms and values existing out-with the organisation. •Implementation of speak-up interventions are either effective, ineffective or indeterminate.•The development of speak-up interventions rarely consider and build-upon existing research findings.•Local speak-up interventions rarely consider and build-upon national or trans-national policy directives.•Speaking-up is shaped by socio-cultural norms and values existing out-with the organisation. Healthcare systems worldwide increasingly value the contribution of employee voice in ensuring the quality of patient care. Although employees’ concerns are often dealt with satisfactorily, considerable evidence suggests that some employees may feel unable to speak-up, and even when they do their concerns may be ignored. As a result, in addition to trans-national and national policies, workplace interventions that support employees to speak-up about their concerns have recently increased. A systematic narrative review, informed by complex systems perspectives addresses the question: “What workplace strategies and/or interventions have been implemented to promote speaking-up by employees”? Thirty-four studies were included in the review. Most studies reported inconclusive results. Researchers explanations for the successful implementation, or otherwise, of speak-up interventions were synthesised into two narrative themes (Braithwaite et al., 2018 (a)) hierarchical, interdisciplinary and cultural relationships and (Francis, 2015 (b)) psychological safety. We strengthen the existing evidence base by providing an in-depth critique of the complex system factors influencing the implementation of speak-up interventions within the healthcare workforce. Although many of the studies were locally unique, there were international similarities in workplace cultures and norms that created contexts inimical to speaking-up interventions. Changing communication behaviours and creating a climate that supports speaking-up is immensely challenging. Interventions can be usurped in practice by complex, emergent and contextual issues, such as pre-existing socio-cultural relationships and workplace hierarchies. Healthcare systems worldwide increasingly value the contribution of employee voice in ensuring the quality of patient care. Although employees' concerns are often dealt with satisfactorily, considerable evidence suggests that some employees may feel unable to speak-up, and even when they do their concerns may be ignored. As a result, in addition to trans-national and national policies, workplace interventions that support employees to speak-up about their concerns have recently increased. A systematic narrative review, informed by complex systems perspectives addresses the question: "What workplace strategies and/or interventions have been implemented to promote speaking-up by employees"? Thirty-four studies were included in the review. Most studies reported inconclusive results. Researchers explanations for the successful implementation, or otherwise, of speak-up interventions were synthesised into two narrative themes (Braithwaite et al., 2018 (a)) hierarchical, interdisciplinary and cultural relationships and (Francis, 2015 (b)) psychological safety. We strengthen the existing evidence base by providing an in-depth critique of the complex system factors influencing the implementation of speak-up interventions within the healthcare workforce. Although many of the studies were locally unique, there were international similarities in workplace cultures and norms that created contexts inimical to speaking-up interventions. Changing communication behaviours and creating a climate that supports speaking-up is immensely challenging. Interventions can be usurped in practice by complex, emergent and contextual issues, such as pre-existing socio-cultural relationships and workplace hierarchies. Healthcare systems worldwide increasingly value the contribution of employee voice in ensuring the quality of patient care. Although employees' concerns are often dealt with satisfactorily, considerable evidence suggests that some employees may feel unable to speak-up, and even when they do their concerns may be ignored. As a result, in addition to trans-national and national policies, workplace interventions that support employees to speak-up about their concerns have recently increased.BACKGROUNDHealthcare systems worldwide increasingly value the contribution of employee voice in ensuring the quality of patient care. Although employees' concerns are often dealt with satisfactorily, considerable evidence suggests that some employees may feel unable to speak-up, and even when they do their concerns may be ignored. As a result, in addition to trans-national and national policies, workplace interventions that support employees to speak-up about their concerns have recently increased.A systematic narrative review, informed by complex systems perspectives addresses the question: "What workplace strategies and/or interventions have been implemented to promote speaking-up by employees"?METHODSA systematic narrative review, informed by complex systems perspectives addresses the question: "What workplace strategies and/or interventions have been implemented to promote speaking-up by employees"?Thirty-four studies were included in the review. Most studies reported inconclusive results. Researchers explanations for the successful implementation, or otherwise, of speak-up interventions were synthesised into two narrative themes (Braithwaite et al., 2018 (a)) hierarchical, interdisciplinary and cultural relationships and (Francis, 2015 (b)) psychological safety.RESULTSThirty-four studies were included in the review. Most studies reported inconclusive results. Researchers explanations for the successful implementation, or otherwise, of speak-up interventions were synthesised into two narrative themes (Braithwaite et al., 2018 (a)) hierarchical, interdisciplinary and cultural relationships and (Francis, 2015 (b)) psychological safety.We strengthen the existing evidence base by providing an in-depth critique of the complex system factors influencing the implementation of speak-up interventions within the healthcare workforce. Although many of the studies were locally unique, there were international similarities in workplace cultures and norms that created contexts inimical to speaking-up interventions. Changing communication behaviours and creating a climate that supports speaking-up is immensely challenging. Interventions can be usurped in practice by complex, emergent and contextual issues, such as pre-existing socio-cultural relationships and workplace hierarchies.CONCLUSIONSWe strengthen the existing evidence base by providing an in-depth critique of the complex system factors influencing the implementation of speak-up interventions within the healthcare workforce. Although many of the studies were locally unique, there were international similarities in workplace cultures and norms that created contexts inimical to speaking-up interventions. Changing communication behaviours and creating a climate that supports speaking-up is immensely challenging. Interventions can be usurped in practice by complex, emergent and contextual issues, such as pre-existing socio-cultural relationships and workplace hierarchies. Background Healthcare systems worldwide increasingly value the contribution of employee voice in ensuring the quality of patient care. Although employees' concerns are often dealt with satisfactorily, considerable evidence suggests that some employees may feel unable to speak-up, and even when they do their concerns may be ignored. As a result, in addition to trans-national and national policies, workplace interventions that support employees to speak-up about their concerns have recently increased. Methods A systematic narrative review, informed by complex systems perspectives addresses the question: "What workplace strategies and/or interventions have been implemented to promote speaking-up by employees"? Results Thirty-four studies were included in the review. Most studies reported inconclusive results. Researchers explanations for the successful implementation, or otherwise, of speak-up interventions were synthesised into two narrative themes (Braithwaite et al., 2018 (a)) hierarchical, interdisciplinary and cultural relationships and (Francis, 2015 (b)) psychological safety. Conclusions We strengthen the existing evidence base by providing an in-depth critique of the complex system factors influencing the implementation of speak-up interventions within the healthcare workforce. Although many of the studies were locally unique, there were international similarities in workplace cultures and norms that created contexts inimical to speaking-up interventions. Changing communication behaviours and creating a climate that supports speaking-up is immensely challenging. Interventions can be usurped in practice by complex, emergent and contextual issues, such as pre-existing socio-cultural relationships and workplace hierarchies. |
| Author | Blake, Joanne Mannion, Russell Adams, Mary Jones, Aled Kelly, Daniel Maben, Jill |
| Author_xml | – sequence: 1 givenname: Aled orcidid: 0000-0002-2921-8236 surname: Jones fullname: Jones, Aled email: jonesa97@cardiff.ac.uk organization: School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, CF24 0XB, UK – sequence: 2 givenname: Joanne surname: Blake fullname: Blake, Joanne email: blakej@cardiff.ac.uk organization: School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, CF24 0XB, UK – sequence: 3 givenname: Mary surname: Adams fullname: Adams, Mary email: mary.adams@kcl.ac.uk organization: King’s Improvement Science, Health Service & Population Research Department, King’s College London, UK – sequence: 4 givenname: Daniel surname: Kelly fullname: Kelly, Daniel email: kellydm@cardiff.ac.uk organization: School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, CF24 0XB, UK – sequence: 5 givenname: Russell surname: Mannion fullname: Mannion, Russell email: r.mannion@bham.ac.uk organization: Health Services Management Centre, School of Social Policy, University of Birmingham, UK – sequence: 6 givenname: Jill orcidid: 0000-0002-6168-0455 surname: Maben fullname: Maben, Jill email: j.maben@surrey.ac.uk organization: School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, UK |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33526279$$D View this record in MEDLINE/PubMed |
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| Keywords | Healthcare systems Speaking-up Workplace culture Patient safety Complex adaptive systems Healthcare policy Narrative review |
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| Snippet | •Implementation of speak-up interventions are either effective, ineffective or indeterminate.•The development of speak-up interventions rarely consider and... Highlights•Implementation of speak-up interventions are either effective, ineffective or indeterminate. •The development of speak-up interventions rarely... Healthcare systems worldwide increasingly value the contribution of employee voice in ensuring the quality of patient care. Although employees' concerns are... Background Healthcare systems worldwide increasingly value the contribution of employee voice in ensuring the quality of patient care. Although employees'... |
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| Title | Interventions promoting employee “speaking-up” within healthcare workplaces: A systematic narrative review of the international literature |
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