A qualitative study of speaking out about patient safety concerns in intensive care units

Summary

Policy to date has mostly focused on the role of 'whistleblowers' in raising concerns about quality and safety of patient care in healthcare settings. However, most opportunities for personnel to identify and act on these concerns are likely to occur much further upstream, in the day-to-day mundane interactions of everyday work. Using qualitative data from over 900 hours of ethnographic observation and 98 interviews across 19 English intensive care units (ICUs), Tarrant et al., in a paper published in Social Science & Medicine, studied how personnel gave voice to concerns about patient safety or poor practice.

Content

Key messages

• Most opportunities to raise safety concerns may arise in routine clinical work.
• Informal strategies for raising concerns are multiple and often effective.
• Use of strategies varies within and between professional groups and hierarchies.
• Increased focus on effective use of informal strategies of social control is needed.