There is growing evidence in healthcare that employee silence (i.e. unwillingness or inability to speak up) is common and is likely to go under the radar. Silence in healthcare has been associated with poor behavior and culture, concealing errors, reduced patient safety, healthcare worker attrition and burnout. Conversely, there is evidence that in organizations where employees are encouraged to speak up about concerns, and where concerns are responded to appropriately, better patient outcomes such as improved patient safety and patient experience occur. However, interventions to promote ‘speaking-up’ in healthcare have largely not been successful and are rooted in a professional culture that does not promote speaking out.
The healthcare sector is a major employer internationally, and is at the forefront in terms of ongoing societal challenges (e.g., Covid-19, climate change, health inequalities and demographic changes). Employee silence in healthcare is ubiquitous and affects employees’ well-being, organizational learning, and their potential to provide safe care to patients. A core challenge in this topic is that certain types and levels of silence can become normalized and viewed as a necessary component of functioning in healthcare. For example, suppressing complaints about working conditions may be a norm that contributes to loyalty and team spirit. Concealing interpersonal tensions may preserve the image of senior healthcare professionals as teachers and healers. Withholding criticisms of an organization or system may keep the public hopeful and supportive in a time of crisis. In this sense, initiatives to encourage healthcare professionals to ‘speak-out’ might take a too narrow perspective and run the risk of ignoring the prevailing professional norms and potential positive effects of silence.
Several recent reviews on speaking up interventions in healthcare have highlighted that many such initiatives achieve disappointing outcomes. The proposed Research Topic is an opportunity to assess the phenomenon of employee silence from a multidisciplinary perspective.
The aims of proposed special collection are twofold; (1) to delineate and discuss both appropriate and inappropriate forms of silence in healthcare, (2) to explore the social, economic and medico-legal factors that either encourages silence or enhance employee silence.
Potential topics for submissions include but are not limited to:
• the role silence plays in healthcare workers’ experiences of their work and profession
• what needs to change for healthcare workers to feel comfortable and safe about sharing information
• the evidence and arguments that some forms of silence play a positive role in healthcare
• current state on how the voice of all agents in healthcare can be heard (e.g., cleaning staff in hospitals, policy makers, relatives of patients, monitoring bodies)
• the evolution of employee voice in early healthcare education and its maintenance throughout the lifespan
• analysis of evidence-based interventions and initiatives successfully addressing voice and silence in the healthcare workplace
There is growing evidence in healthcare that employee silence (i.e. unwillingness or inability to speak up) is common and is likely to go under the radar. Silence in healthcare has been associated with poor behavior and culture, concealing errors, reduced patient safety, healthcare worker attrition and burnout. Conversely, there is evidence that in organizations where employees are encouraged to speak up about concerns, and where concerns are responded to appropriately, better patient outcomes such as improved patient safety and patient experience occur. However, interventions to promote ‘speaking-up’ in healthcare have largely not been successful and are rooted in a professional culture that does not promote speaking out.
The healthcare sector is a major employer internationally, and is at the forefront in terms of ongoing societal challenges (e.g., Covid-19, climate change, health inequalities and demographic changes). Employee silence in healthcare is ubiquitous and affects employees’ well-being, organizational learning, and their potential to provide safe care to patients. A core challenge in this topic is that certain types and levels of silence can become normalized and viewed as a necessary component of functioning in healthcare. For example, suppressing complaints about working conditions may be a norm that contributes to loyalty and team spirit. Concealing interpersonal tensions may preserve the image of senior healthcare professionals as teachers and healers. Withholding criticisms of an organization or system may keep the public hopeful and supportive in a time of crisis. In this sense, initiatives to encourage healthcare professionals to ‘speak-out’ might take a too narrow perspective and run the risk of ignoring the prevailing professional norms and potential positive effects of silence.
Several recent reviews on speaking up interventions in healthcare have highlighted that many such initiatives achieve disappointing outcomes. The proposed Research Topic is an opportunity to assess the phenomenon of employee silence from a multidisciplinary perspective.
The aims of proposed special collection are twofold; (1) to delineate and discuss both appropriate and inappropriate forms of silence in healthcare, (2) to explore the social, economic and medico-legal factors that either encourages silence or enhance employee silence.
Potential topics for submissions include but are not limited to:
• the role silence plays in healthcare workers’ experiences of their work and profession
• what needs to change for healthcare workers to feel comfortable and safe about sharing information
• the evidence and arguments that some forms of silence play a positive role in healthcare
• current state on how the voice of all agents in healthcare can be heard (e.g., cleaning staff in hospitals, policy makers, relatives of patients, monitoring bodies)
• the evolution of employee voice in early healthcare education and its maintenance throughout the lifespan
• analysis of evidence-based interventions and initiatives successfully addressing voice and silence in the healthcare workplace
