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‘Saying it without words’: a qualitative study of oncology staff's experiences with speaking up about safety concerns
OBJECTIVES: To explore the experiences of oncology staff with communicating safety concerns and to examine situational factors and motivations surrounding the decision whether and how to speak up using semistructured interviews. SETTING: 7 oncology departments of six hospitals in Switzerland. PARTIC...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025461/ https://www.ncbi.nlm.nih.gov/pubmed/24838725 http://dx.doi.org/10.1136/bmjopen-2013-004740 |
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author | Schwappach, D L B Gehring, K |
author_facet | Schwappach, D L B Gehring, K |
author_sort | Schwappach, D L B |
collection | PubMed |
description | OBJECTIVES: To explore the experiences of oncology staff with communicating safety concerns and to examine situational factors and motivations surrounding the decision whether and how to speak up using semistructured interviews. SETTING: 7 oncology departments of six hospitals in Switzerland. PARTICIPANTS: Diverse sample of 32 experienced oncology healthcare professionals. RESULTS: Nurses and doctors commonly experience situations which raise their concerns and require questioning, clarifying and correcting. Participants often used non-verbal communication to signal safety concerns. Speaking-up behaviour was strongly related to a clinical safety issue. Most episodes of ‘silence’ were connected to hygiene, isolation and invasive procedures. In contrast, there seemed to exist a strong culture to communicate questions, doubts and concerns relating to medication. Nearly all interviewees were concerned with ‘how’ to say it and in particular those of lower hierarchical status reflected on deliberate ‘voicing tactics’. CONCLUSIONS: Our results indicate a widely accepted culture to discuss any concerns relating to medication safety while other issues are more difficult to voice. Clinicians devote considerable efforts to evaluate the situation and sensitively decide whether and how to speak up. Our results can serve as a starting point to develop a shared understanding of risks and appropriate communication of safety concerns among staff in oncology. |
format | Online Article Text |
id | pubmed-4025461 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-40254612014-05-21 ‘Saying it without words’: a qualitative study of oncology staff's experiences with speaking up about safety concerns Schwappach, D L B Gehring, K BMJ Open Health Services Research OBJECTIVES: To explore the experiences of oncology staff with communicating safety concerns and to examine situational factors and motivations surrounding the decision whether and how to speak up using semistructured interviews. SETTING: 7 oncology departments of six hospitals in Switzerland. PARTICIPANTS: Diverse sample of 32 experienced oncology healthcare professionals. RESULTS: Nurses and doctors commonly experience situations which raise their concerns and require questioning, clarifying and correcting. Participants often used non-verbal communication to signal safety concerns. Speaking-up behaviour was strongly related to a clinical safety issue. Most episodes of ‘silence’ were connected to hygiene, isolation and invasive procedures. In contrast, there seemed to exist a strong culture to communicate questions, doubts and concerns relating to medication. Nearly all interviewees were concerned with ‘how’ to say it and in particular those of lower hierarchical status reflected on deliberate ‘voicing tactics’. CONCLUSIONS: Our results indicate a widely accepted culture to discuss any concerns relating to medication safety while other issues are more difficult to voice. Clinicians devote considerable efforts to evaluate the situation and sensitively decide whether and how to speak up. Our results can serve as a starting point to develop a shared understanding of risks and appropriate communication of safety concerns among staff in oncology. BMJ Publishing Group 2014-05-16 /pmc/articles/PMC4025461/ /pubmed/24838725 http://dx.doi.org/10.1136/bmjopen-2013-004740 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/ |
spellingShingle | Health Services Research Schwappach, D L B Gehring, K ‘Saying it without words’: a qualitative study of oncology staff's experiences with speaking up about safety concerns |
title | ‘Saying it without words’: a qualitative study of oncology staff's experiences with speaking up about safety concerns |
title_full | ‘Saying it without words’: a qualitative study of oncology staff's experiences with speaking up about safety concerns |
title_fullStr | ‘Saying it without words’: a qualitative study of oncology staff's experiences with speaking up about safety concerns |
title_full_unstemmed | ‘Saying it without words’: a qualitative study of oncology staff's experiences with speaking up about safety concerns |
title_short | ‘Saying it without words’: a qualitative study of oncology staff's experiences with speaking up about safety concerns |
title_sort | ‘saying it without words’: a qualitative study of oncology staff's experiences with speaking up about safety concerns |
topic | Health Services Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025461/ https://www.ncbi.nlm.nih.gov/pubmed/24838725 http://dx.doi.org/10.1136/bmjopen-2013-004740 |
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