Healthcare Employees Can Work in a ‘Culture of Fear’, Where Speaking Up is Discouraged

MedicalResearch.com Interview with:

Professor Mary Dixon-Woods Director, The Healthcare Improvement Studies Institut (THIS Institute) University of Cambridge

Prof. Dixon-Woods

Professor Mary Dixon-Woods
Director, The Healthcare Improvement Studies Institute
(THIS Institute)
University of Cambridge 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The challenges around employee voice are well documented. For various reasons, employees in all industries are often reluctant to raise concerns when they witness disruptive or unsafe behaviour from their colleagues. But it’s crucial that they speak up – especially in healthcare. Patient safety may depend on it.

Our study focused on a large academic medical centre in the US that wanted to improve employee voice. Despite having reporting mechanisms in place, the organisation still had issues with disruptive behaviour from group of powerful senior individuals that went unchallenged and contributed to a culture of fear.

Through confidential interviews with 67 frontline staff and leaders and the organizational actions that followed, we learned it’s important for employees to feel that their concerns will be dealt with authentically. It also helps when healthcare organisations have clear definitions of acceptable and unacceptable behaviour and well-coordinated response mechanisms. Once someone does raise a concern, organizations need good, fair and transparent systems of investigations and be prepared to implement consequences for disruptive behaviour consistently.  Continue reading