Cargando…

‘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...

Descripción completa

Detalles Bibliográficos
Autores principales: Schwappach, D L B, Gehring, K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2014
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
_version_ 1782316764381577216
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
work_keys_str_mv AT schwappachdlb sayingitwithoutwordsaqualitativestudyofoncologystaffsexperienceswithspeakingupaboutsafetyconcerns
AT gehringk sayingitwithoutwordsaqualitativestudyofoncologystaffsexperienceswithspeakingupaboutsafetyconcerns