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Showing results for tags 'Culture of fear'.
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Content ArticleSeveral accidents have shown that crew members’ failure to speak up can have devastating consequences. Despite decades of crew resource management (CRM) training, this problem persists and still poses a risk to flight safety. This study aimed to understand why crew members choose silence over speaking up. The authors explored past speaking up behaviour and the reasons for silence in 1,751 crew members, who reported to have remained silent in half of all speaking up episodes they had experienced. Reasons for silence mainly concerned fear of damaging relationships, fear of punishment and operational pressures. The study identified significant group differences in the frequencies and reasons for silence and recommends interventions to specifically and effectively foster speaking up.
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Content Article
Mersey Care's Civility Jigsaw
Patient_Safety_Learning posted an article in Bullying and fear
In this 2 minute film, Jennifer Cooke from the Community Mental Health team, talks about a special Just and Learning resource, created by Mersey Care called the Civility Jigsaw. She explains how their team used it to facilitate difficult conversations about inappropriate behaviour in the workplace and how powerful it was a tool for change.- Posted
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Content ArticleIn this 3.5 minute film, Mersey Care looks at what bullying is and how it can have a devastating impact on staff. It forms part of their work to encourage people to feel safe in speaking up about bullying and build a positive working environment.
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Content ArticleThose who have read Professor Edmondson's book "The Fearless Organization" will know that psychological safety is required for team high-performance. Psychological safety is defined as "a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes". If you do not feel safe in a group, you are likely to keep ideas to yourself and avoid speaking up, even about risks. Furthermore, if mistakes are held against you, you then look to avoid making mistakes and so stop taking risks, rather than making the most out of your talents. Low psychological safety, therefore, gets in the way of both team performance, innovation, learning, and personal success. For you to be successful in your team, and "as a team", psychological safety is the enabler. In collaboration with professor Amy C. Edmondson, The Fearless Organization has developed 'The Fearless Organization Scan'. This scan maps how team members perceive the level of psychological safety in their closest context. To improve team performance, it helps to know the Psychological Safety levels in your team, as this is a critical predictor of how your team will learn and work together. By improving the level of psychological safety, you significantly increase the likelihood of team success.
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- Staff factors
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Content ArticleAs highlighted by NHS England with the NHS People Plan[, healthcare organisations that prioritise workforce wellbeing will be better placed to put lessons learnt from the coronavirus pandemic into practice. Phil Taylor of RLDatix outlines the benefits of introducing a just culture not a blame culture and shares a methodology for positive change.
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Content ArticlePatientSafe Network in Australia has been promoting the theatre cap challenge across the world. By wearing your name on your theatre cap it can improve team work and patient safety. Here, Rob Hackett discusses the challenges in trying to change the 'system'.
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- Patient safety strategy
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Content ArticleJeremy Hunt asks the Secretary of State for Health and Social Care, Helen Whately, what proportion of NHS staff have experienced bullying and harassment in the workplace in each year from 2010 to 2020.
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Content ArticleSo far in our 2020 overview series, we’ve heard an introduction to how the year has gone from our Chief Executive Helen Hughes, and looked at the impact of the COVID-19 pandemic on patient safety, as well as the work we’ve done in the areas of Long COVID and painful hysteroscopies. In our penultimate blog of the series, we turn our attention to the work we’ve done in staff safety.
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Content Article
Organisational silence in the NHS: ‘Hear no, See no, Speak no’
Sam posted an article in Bullying and fear
There have been major healthcare failings in the UK NHS over many years. The persistent dysfunctional organisational culture, an inability to learn and the need for change has been identified within literature. The concept of organisational silence forms one aspect of the proposed model of organisational dysfunction in the NHS. Forty-three interviews and six focus groups have been conducted to test the model. From generalised evidence, it is suggested that the NHS is systemically and institutionally deaf, bullying, defensive and dishonest. There appears to be a culture of fear, lack of voice and silence. The cost of suppression of voice, reluctance to voice and the resulting ‘sea of silence’ is immense. There is a resistance to ‘knowing’ and the NHS appears to be hiding and retreating from reality. There is an urgent need for action to be taken to address this dysfunctional culture. The NHS needs to embrace the identity of being a listening, learning and honest organisation, with a culture of respect. It needs to choose to hear, see and speak for the benefit of patients and staff. There are implications for the wider UK society due to the apparent inability to learn and improve.- Posted
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Content ArticleUsing a spectrum of measures, this paper from Kline and Lewis estimates some of the financial costs of bullying and harassment to the NHS in England. By means of specific impacts resulting from bullying and harassment to staff health, sickness absence costs to the employer, employee turnover, diminished productivity, sickness presenteeism, compensation, litigation and industrial relations costs, we conservatively estimate bullying and harassment to cost the taxpayer £2.281 billion per annum. The evidence in this paper indicates the importance of urgent material engagement to address bullying in the UK NHS. Existing staff surveys fail to capture the types of behaviours often attributable to bullying and this should be a focus to design pertinent interventions. Capturing bystander/witness experiences are undocumented, as are workplace incivilities and staff satisfaction with policy and procedures for tackling bullying. Policy change is vital for accurately capturing the costs of bullying associated with absenteeism, staff replacement, productivity reductions and to use these as mechanisms to manage organizations that fail to address bullying.
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Content ArticleIn her guest blog for the Professionals Standard Body (PSB), Sarah Seddon talks about the Duty of Candour and how it's affected her personal life.
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Content ArticleThis year's World Patient Safety Day focuses on both patient and staff safety. Human Factors science keeps patients safe, but also helps keep staff safe, physically and psychologically. Martin Bromiley has written a a special one page opinion piece for the Clinical Human Factors Group about the behaviours that help create psychological safety.
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Eric Kutscher: First, do no harm—but did I?
Patient Safety Learning posted an article in Blogs
The cost of providing care during a pandemic is seeing firsthand the evolution of medical knowledge, and wishing current data could have guided past decisions, says Eric Kutscher in this BMJ Opinion article.- Posted
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- Organisational learning
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“I’m going to Datix you”
Jonathan posted an article in Investigations, risk management and legal issues
Most healthcare professionals are familiar with Datix incident reporting software. But how and why has Datix become associated with fear and blame? Datix’s former chief executive and now chairman of Patient Safety Learning, Jonathan Hazan, looks at why this has come about and what needs to be done to improve incident reporting.- Posted
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Content ArticleOn Thursday 30 July 2020, NHS England and NHS Improvement published the NHS People Plan for 2020/21. Building on the Interim NHS People Plan released in 2019, it describes itself as focusing on “how we must all continue to look after each other and foster a culture of inclusion and belonging, as well as action to grow our workforce, train our people, and work together differently to deliver patient care”. In this blog, Patient Safety Learning looks at the People Plan with specific reference to its approach to tackling the blame culture in the NHS, which is a significant factor in the safety of patients and staff. It highlights where we think the People Plan has not addressed these well-known concerns and what more needs to be done urgently.
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Content ArticleFindings from the APPG for Whisltblowing's report show that whistleblowing cases continue to have a low success rate, with whistleblowers suffering more and for longer than before, writes Mary Robinson. Whilst there are laws in place to protect whistleblowers, the overwhelming evidence is that they have failed to address the principal issues they face. Politicians have a duty to confront the most difficult things, including the barriers to justice and the fear of retaliation that make it impossible or futile for people across all sectors to speak up safely. Mary, the Conservative MP for Cheadle and chair of the APPG for whistleblowing, says that a system that works with whistleblowers instead of against them, would serve to protect employees and would empower them to do the right thing. Although the UK was the first in Europe to introduce legislation with Public Interest Disclosure Act 1998, we are in danger of falling behind global best practice. In this blog, Mary proposes and urgent reform of existing legislation and the introduction of an Office of the Whistleblower is needed to reset the gold standard.
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Content ArticleAt its heart, Appreciative Inquiry (AI) is about the search for the best in people, their organisations, and the strengths-filled world around them. It is the art and practice of asking questions that strengthen a system’s capacity to heighten positive potential, (Stavros et. al (2015) Appreciative Inquiry: Organisation Development and the Strengths Revolution). In this area you will find useful resources relating to the aspect covered below.
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- Communication
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Content Article
What is civility?
Claire Cox posted an article in Stories from the front line
In this short video, Dr Michael Kaufmann discusses five fundamentals of civility and how to be civil in a healthcare workplace. Dr Michael Kaufmann is a Consultant in physician health and addiction medicine and Medical Director of the Physician Workplace Support Program (PWSP).- Posted
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Content ArticleIn healthcare systems safety needs to be conceived in a relational as well as a regulatory framework, with resilience being understood as the interplay between both elements. This presentation from the Australian Institute of Health Innovation, critically appraises how harm is understood and responded to within the New Zealand health system and the potential contribution of restorative responses. A major and internationally unprecedented project, that employed a restorative approach to address the harm caused to patients and professionals by the use of surgical mesh in New Zealand (NZ), is used to illustrate the case for change.
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- Investigation
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Content ArticleThe contents of this book are based on the experiences of: NHS patients who have experienced avoidable harm, and associated cover-ups. NHS staff who have suffered detriment for speaking out on behalf of the above. The author's own experience as an employee of St George's hospital, Tooting, and doing locum work at hospitals in London and the Home Counties. Written from the perspective of an NHS Operating Department Practitioner, and whistleblower, NHS Dirty Secrets describes how the NHS cover-up culture is a risk to patient safety, and how employment and promotion practices are skewed in favour of those most likely to support the NHS cover-up culture. The NHS cover-up culture, itself, is decomposed and analysed, with examples given as to the methods used to support the hiding of issues, such as patient deaths, from public scrutiny.
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- Whistleblowing
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Content ArticleIn this article, published by the BMJ, Professor Russell Mannion and Professor Huw Davies explore how notions of culture relate to service performance, quality, safety and improvement.
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Content ArticleIn this article, published by the British Journal of Anaesthesia, the author looks at the impact a culture of blame can have upon NHS staff, including suicide, and offers recommendations for what should change.
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- Culture of fear
- Transformation
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Content Article
No blame culture, a blog by Joanne Hughes
PatientSafetyLearning Team posted an article in Bullying and fear
In this powerful blog, based on her personal experience of losing a child, Joanne Hughes argues you can (and should) identify and blame the error, the 'act or omission’ for the harm, but very often it is not appropriate or fair to blame the 'person' who carried out that act. Avoidably grieving parents, she highlights, do need to know 'what' is to blame and 'why' it occurred.- Posted
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Freedom to Speak Up Guardian survey 2019
Patient Safety Learning posted an article in Speak Up Guardians
A new report published by the National Guardian’s Office reveals that the perception of the speaking up culture in health is improving. An annual survey, conducted by the National Guardian’s Office, asked Freedom to Speak Up Guardians, and those in a supporting role, about how speaking up is being implemented in their organisation. The results reveal details about the network’s demographics and their perceptions of the impact of their role. This infographic highlights some of the findings.- Posted
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Maintaining emotional safety: From a nurse's perspective
Claire Cox posted an article in Cancers
Kay Bell, from the Royal Marsden Hospital, speaks to ecancer at the 2019 UKONS meeting about the importance of emotional safety for nurses. She gives an overview of the key messages of this session, which include taking the time to pause and reflect on a situation. Kay also discusses the support available for nurses currently which include clinical supervision, mentoring support from different professional organisations.- Posted
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