@article{ref1,
title="When silence is dangerous: "speaking-up" about safety concerns",
journal="Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen",
year="2016",
author="Schwappach, David L. B.",
volume="114",
number="",
pages="5-12",
abstract="BACKGROUND: Open and direct communication (&quot;speaking-up&quot;) about errors, bypassed safety rules and risky behaviours among hospital staff is required to avoid patient harm, and it is an essential characteristic of an established safety culture. In German-speaking countries, little is known about speaking-up behaviour among health care professionals (HCPs) in hospitals. <br><br>METHOD: Safety concerns and speaking-up behaviours among HCPs of nine oncological units of eight hospitals were assessed using a self-administered survey. A vignette was embedded to assess hypothetical speaking-up and its predictors. The association of hierarchical position and speaking-up was investigated. 1,013 physicians and nurses completed the survey (65 % response rate). <br><br>RESULTS: 53 % of the HCPs reported having concerns about patient safety at their unit, &quot;sometimes&quot;, &quot;frequently&quot;, or &quot;very frequently&quot;. Colleagues bypassing important safety rules at least &quot;sometimes&quot; were reported by 30 %. A considerable fraction of responders reported episodes of withholding of voice. Nearly 20 % said they did not communicate safety problems at their unit at least sometimes. 73 % of higher-ranking staff and 60 % among those at lower ranks said they had never withheld information which could have reduced threats to patients (OR=1.8, p≤0.001). Many responders felt that speaking-up is often difficult and challenging. 32 % responded that they would not speak-up about a missed hand disinfection towards a colleague assessing the wound of a recently operated oncological patient. <br><br>CONCLUSIONS: HCPs in hospital frequently experience safety concerns and often withhold them. An important resource for better patient safety is lost. The development of interventions to improve speaking-up culture is warranted.<br><br>Copyright © 2016. Published by Elsevier GmbH.<p /> <p>Language: de</p>",
language="de",
issn="1865-9217",
doi="10.1016/j.zefq.2016.05.011",
url="http://dx.doi.org/10.1016/j.zefq.2016.05.011"
}