Likelihood of Speaking Up by Health Professionals in Emergency Setting: A Descriptive Study

Introduction: Speaking up is critical for patient safety, but many health-care professionals are hesitant to do so. Understand­ing the factors influencing can help to improve speaking-up behavior and team communication. The aim of the study was to investigate the health professionals’ likelihood of speaking up about safety concerns and associ­ated barriers to speaking up for safety.

Materials and methods: A descriptive cross-sectional study was conducted at Emergency Departments of three Teaching Hospitals in Colombo district, Sri Lanka with the sample of 155 of doctors and nurses. Data was collected through a self-administered questionnaire designed to assess attitudes, barriers, and facilitators for speaking up, and self-reported experience with speaking up. The likelihood of speaking up and the potential for patient harm were assessed.

Results: 33.6% of participants have reported they would not withhold their voice during a patient safety concern while 56% would often bring up specific concerns on patient safety. 38.7% reports patient safety concerns on each shift or daily during their work. More than 50% are comfortable with working culture but are concerned with constant reminding of safety rules (64.4%) and discouraged due to unchanged attitudes after address­ing patient safety concerns (62%). Workload (65.2%), hierarchy (62.6%), feared consequences of speaking up (56.1%), and powerlessness (50.3%) identified as major barriers in speaking up for safety.

Discussion: Contextual considerations have a significant impact on doctors’ and nurses’ willingness to speak up regarding patient safety. Speaking up leads to significant discomfort among doctors and nurses who aren’t in manage­rial positions. Staff should be given clear instructions and training on when and how to raise safety concerns in Emergency Department.