Montgomery, A, Lainidi, O, Johnson, J orcid.org/0000-0003-0431-013X et al. (13 more authors) (Cover date: January/March 2023) Employee silence in health care: Charting new avenues for leadership and management. Health Care Management Review, 48 (1). pp. 52-60. ISSN 0361-6274
Abstract
Issue
Health care management is faced with a basic conundrum about organizational behavior; why do professionals who are highly dedicated to their work choose to remain silent on critical issues that they recognize as being professionally and organizationally significant? Speaking-up interventions in health care achieve disappointing outcomes because of a professional and organizational culture that is not supportive.
Critical Theoretical Analysis
Our understanding of the different types of employee silence is in its infancy, and more ethnographic and qualitative work is needed to reveal the complex nature of silence in health care. We use the sensemaking theory to elucidate how the difficulties to overcoming silence in health care are interwoven in health care culture.
Insight/Advance
The relationship between withholding information and patient safety is complex, highlighting the need for differentiated conceptualizations of silence in health care. We present three Critical Challenge points to advance our understanding of silence and its roots by (1) challenging the predominance of psychological safety, (2) explaining how we operationalize sensemaking, and (3) transforming the role of clinical leaders as sensemakers who can recognize and reshape employee silence. These challenges also point to how employee silence can also result in a form of dysfunctional professionalism that supports maladaptive health care structures in practice.
Practice Implications
Delineating the contextual factors that prompt employee silence and encourage speaking up among health care workers is crucial to addressing this issue in health care organizations. For clinical leaders, the challenge is to valorize behaviors that enhance adaptive and deep psychological safety among teams and within professions while modeling the sharing of information that leads to improvements in patient safety and quality of care.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 Wolters Kluwer Health, Inc. All rights reserved. This is an author produced version of an article, published in Health Care Management Review. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Employee silence; health care; psychological safety; speaking up |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Psychology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 30 Jun 2022 13:46 |
Last Modified: | 16 Jun 2023 00:13 |
Status: | Published |
Publisher: | Lippincott, Williams & Wilkins |
Identification Number: | 10.1097/hmr.0000000000000349 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:188279 |