Speaking up behaviors and safety climate in an Austrian university hospital. (26th April 2018)

• Record Type: Journal Article
• Authors: Schwappach, David; Sendlhofer, Gerald; Häsler, Lynn; Gombotz, Veronika; Leitgeb, Karina; Hoffmann, Magdalena; Jantscher, Lydia; Brunner, Gernot
• Is Part Of: International journal for quality in health care. Volume 30:Number 9(2018:Nov.)
• Page Start: 701
• Page End: 707
• Publication Date: 2018-04-26
• Subjects: Speaking up -- patient safety -- safety culture -- communication -- survey; Medical care -- Quality control -- Periodicals; 362.1068
• DOI: 10.1093/intqhc/mzy089
• Languages: English
• ISSNs: 1353-4505

Abstract

Abstract: Objective: To analyze speaking up behavior and safety climate with a validated questionnaire for the first time in an Austrian university hospital. Design: Survey amongst healthcare workers (HCW). Data were analyzed using descriptive statistics, Cronbach's alpha was calculated as a measure of internal consistencies of scales. Analysis of variance and t -tests were used. Setting: The survey was conducted in 2017. Participants: About 2.149 HCW from three departments were asked to participate. Intervention: To measure speaking up behavior and safety climate. Main Outcome Measure: To explore psychological safety, encouraging environment and resignation towards speaking up. Results: About 859 evaluable questionnaires were returned (response rate: 40%). More than 50% of responders perceived specific concerns about patient safety within the last 4 weeks and observed a potential error or noticed rule violations. For the different items, between 16% and 42% of HCW reported that they remained silent though concerns for safety. In contrast, between 96% and 98% answered that they did speak up in certain situations. The psychological safety for speaking up was lower for HCW with a managerial function ( P < 0.001). HCW with managerial functions perceived the environment as less encouraging to speak up ( P < 0.05) than HCW without managerial function. Conclusions: We identified speaking up behaviors for the first time in an Austrian university hospital. Only moderately frequent concerns were in conflict with frequent speaking up behaviors. These results clearly show that a paradigm shift is needed to increase speaking up culture.