This study in BMJ Open considers how the usefulness of internal whistleblowing is affected by other institutional processes in healthcare organisations. The authors examine how the effectiveness of formal inquiries (in response to employees raising concerns) affects the utility of whistleblowing. The study used computer simulations to test the utility of several whistleblowing policies in a variety of organisational contexts.
This study found that:
- organisational inefficiencies can have a negative impact on the benefits of speaking up about poor patient care
- where resources are limited and reviews less efficient, it can actually improve patient care if whistleblowing rates are limited
- including 'softer' mechanisms for reporting concerns (for example, peer to peer conversation) alongside whistleblowing policies, can overcome these organisational limitations.