Richmond John G, Burgess Nicola
School of Health and Related Research, The University of Sheffield, Sheffield, UK.
Warwick Business School, University of Warwick, Coventry, UK.
J Health Organ Manag. 2023 Feb 28;ahead-of-print(ahead-of-print). doi: 10.1108/JHOM-01-2022-0027.
Supporting and nurturing effective communication between healthcare professionals is vital to protect patients from harm. However, not all forms of employee voice are effective. Fear can lead to defensive voice, while the role of other emotions to drive voice behaviour is less well understood. This paper aims to understand what role the broader range of emotions, including compassion and shame, experienced by healthcare professionals following patient safety incidents (PSI) play in the subsequent enactment of prosocial voice, a positive and other-oriented form of communication.
DESIGN/METHODOLOGY/APPROACH: This study is based on data from a single English NHS hospital: interviews with healthcare professionals involved in PSIs ( = 40), observations at quality and risk committees and meetings ( = 26 h) and review of investigative documents ( = 33). Three recent PSIs were selected for cross-case analysis based upon organisational theory related to professional hierarchy, employee voice and literature on emotions.
Among three cases, the authors found variance in context, emotional experience and voice behaviour. Where professionals feared blame and repercussion, voice was defensive. Meanwhile where they experienced shame and compassion, prosocial voice was enacted to protect patients.
Healthcare organisations seeking to foster prosocial voice should: (1) be more considerate of professionals' emotional experiences post-PSI and ensure adequate support for recovery (2) establish norms for professionals to share their struggles with others (3) reward professionals who demonstrate caring behaviour (4) buffer professionals from workplace pressures.
ORIGINALITY/VALUE: The authors' study highlights how emotional experiences, such as shame and compassion, can mediate blame and defensiveness and lead to the enactment of prosocial voice in the professional hierarchy.
支持和培养医疗保健专业人员之间的有效沟通对于保护患者免受伤害至关重要。然而，并非所有形式的员工发声都是有效的。恐惧可能导致防御性发声，而其他情绪对发声行为的驱动作用则鲜为人知。本文旨在了解医疗保健专业人员在患者安全事件（PSI）后所经历的更广泛的情绪，包括同情和羞耻，在随后亲社会发声（一种积极的、以他人为导向的沟通形式）的表现中所起的作用。
设计/方法/途径：本研究基于一家英国国民保健服务（NHS）医院的数据：对参与患者安全事件的医疗保健专业人员进行访谈（n = 40）、对质量和风险委员会及会议进行观察（n = 26小时）以及审查调查文件（n = 33）。根据与职业等级制度、员工发声相关的组织理论以及关于情绪的文献，选择了三个近期的患者安全事件进行跨案例分析。
在三个案例中，作者发现情境、情感体验和发声行为存在差异。当专业人员担心受到指责和影响时，发声是防御性的。与此同时，当他们经历羞耻和同情时，会采取亲社会发声来保护患者。
寻求促进亲社会发声的医疗保健组织应：（1）更加体谅专业人员在患者安全事件后的情感体验，并确保为其恢复提供充分支持；（2）建立规范，让专业人员能够与他人分享自己的困难；（3）奖励表现出关爱行为的专业人员；（4）减轻专业人员的工作压力。
原创性/价值：作者的研究强调了羞耻和同情等情感体验如何调节指责和防御心理，并导致在职业等级制度中出现亲社会发声。
