Management responses to staff speaking up in a UK healthcare setting

Ghorbankhani, Melika 2024. Management responses to staff speaking up in a UK healthcare setting. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Background: In healthcare, encouraging staff to voice concerns about patient safety is fundamental. However, the literature often overlooks the equally important aspect of responding to these concerns. The NHS needs help to effectively address employee-raised patient safety concerns, resulting in missed opportunities to prevent patient harm and hindered organisational learning. To bridge this gap, my study aims to explore managers’ experiences in handling staff concerns and to identify factors that facilitate or impede their responses to patient safety issues raised by staff. With the potential for significant improvement, I seek to assist managers in addressing staff concerns optimally and fostering a culture of continuous learning for enhanced patient care. Study Design: The study utilised an Exploratory-Descriptive Qualitative Research approach. Participant Managers were purposefully selected with direct experience in addressing staff concerns, employing a snowball sampling technique to gain an in-depth understanding of the topic. Data were collected through individual semi-structured interviews and analysed using Braun & Clarke’s six-step framework. Findings: Managers’ responses to staff concerns within the NHS are influenced by three primary themes. Cultural factors are crucial, as cultures of trust and openness promote responsive management, while reactive cultures hinder it. Structural factors, including the distribution of power and resources within managerial hierarchies, impede managers’ ability to address staff concerns effectively. Additionally, individual factors such as managers’ practical knowledge and leadership qualities enhance their responsiveness, whereas tendencies toward self-preservation inhibit it. Conclusions: The study reveals that managers reactively address staff concerns about patient safety due to insufficient support structures. This deficiency hampers the development of essential managerial skills and proactive protocols, leading managers to prioritise self-preservation over risk-taking when handling staff concerns. Consequently, a culture needing more proactive measures results in concerns being addressed only after escalation, leading to minimal learning or change. This cyclical approach causes recurring issues and diminishes the effectiveness of speaking up and responding.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Healthcare Sciences
Date of First Compliant Deposit:	19 February 2025
Last Modified:	19 Feb 2025 15:57
URI:	https://orca.cardiff.ac.uk/id/eprint/176313

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