Open Communication Culture Research Articles

A spiral of voice? When employees speak up on internal social media

PurposeThe purpose of this paper is to explore the discursive tactics that employees use when they speak up on internal social media (ISM) to gain support for their cause, and how this can develop into a “spiral of voice” when organizational members interact with each other on ISM.Design/methodology/approachThe study is based on screenshots of four months of coworker communication on ISM in a Danish bank and on semi-structured interviews with 24 employees.FindingsEmployees succeeded in speaking up and gaining support on ISM by using eight different discursive tactics. These tactics helped move organizational issues from an operational to a strategic level, thus making the issues relevant for management as well as gaining the support of other coworkers. The visibility and persistence of communication on ISM forced managers to react.Research limitations/implicationsFurther research should investigate whether similar tactics and reactions occur in organizations with a less open communication culture where it might be less safe for employees to speak up.Practical implicationsOrganizations need to be aware of the dynamics of the “spiral of voice” and of the way in which the visibility and persistence of communication on ISM forces managers to handle organizational issues.Originality/valueThis study is the first to explore what happens when employees speak up on ISM and to propose the concept of “a spiral of voice” as an extension of the theory of “the spiral of silence” (Noelle-Neumann, 1974).

The impact of patient safety culture on handover in rural health facilities

BackgroundEffective handover is crucial for patient safety. Rural health care organisations have particular challenges in relation to handover of information, placing them at higher risk of adverse events. Few studies have examined the relationship between handover and patient safety in rural contexts, particularly in Australia. This study aimed to explore the effect of handover on overall perceptions of patient safety and the effect of other patient safety dimensions on handover in a rural Australian setting.MethodsA cross-sectional online survey using The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture was implemented across six rural Local Health Districts in NSW, Australia and resulted in 1587 respondents. Hierarchical multiple linear regression analysis was conducted to account for the nested nature of the data. Models were developed to assess the effect of handover on patient safety perceptions, and the effect of other patient safety culture composites on handover variables. Open-ended questions about patient safety were inductively analyzed for themes. Quotes from the handover theme are presented.ResultsAll models were significant overall (p < .001), with explanatory powers ranging from 29 to 48%. Within rural health settings, effective handover is significantly related to patient safety perceptions (R2 = .29). A strong teamwork culture and management support culture was found to enhance effective handover of patient information (R2 = .47), and effective handover of personal responsibility (R2 = .37). A strong teamwork, management support, and open communication culture enhances handover of department accountability (R2 = .41).Despite the implementation of standardised communication tools and frameworks for handover, patient safety is compromised by inadequate coordination, poor or absent documentation between departments, between other health care agencies and in transfer of care from acute facilities to primary/community care.ConclusionApproaches to handover need to consider the particular challenges associated with rurality and strengthening elements found to be associated with increased safety, such as a strong teamwork and management culture and good reporting practices. Research is required to examine how communication at transition of care, particularly between facilities, is conducted and ways in which to enhance patients’ and families’ participation.

Risk Management Strategies of Non-Banking Financial Institutions: A Survey Based Analysis of Financial Experts

This research helps in identifying and analysing the risk management strategies of non-banking financial institutions (NBFIs) Existing research finds that NBFIs use various risk management strategies, such as diversification, hedging, and insurance, to manage their risks. Additionally, there have been several challenges identified within this field that NBFIs face in implementing RMS, such as inadequate resources, lack of expertise, and regulatory constraints. There is an increasing importance to developing comprehensive risk management strategies that are tailored to the specific needs of NBFIs. It also emphasizes the need for NBFIs to increase their awareness of the potential risks they face and to implement measures to mitigate those risks. Additionally, an underscoring of the importance of having a robust risk culture within NBFIs, which involves promoting a risk-aware mindset among employees and encouraging a culture of open communication and transparency. The study provides useful insights for NBFIs in improving their risk management practices and for regulators in formulating policies to enhance the resilience of the financial system. The researcher had conducted the study survey with the help of a structured questionnaire on 200 respondents (financial experts) to know different Risk Management Strategies of Non-Banking Financial Institutions and concludes that there is significant effect of Risk Management Strategies of Non-Banking Financial Institutions.

THE RELATIONSHIP BETWEEN PERCEIVED AUTONOMY SUPPORT AND PERCEIVED JUSTICE

Previous studies have a little attention on the impact of perceived autonomy support on the justice. This study examines the impact of perceived autonomy support from supervisor and from environment toward perceived procedural justice and interpersonal justice. Based on self interest model and basic need theory, this study hypothesized that individual’s perception of autonomy supported both from supervisor and work environment would affect his/ her perception of procedural. Based on need fulfillment theory, this study hypothesized that individuals’perception of autonomy supported both from supervisor and work environment affect interpersonal justice. This study used 234 lecturers for sample and regression analysis for analizing the data. The results support the hypotheses that the higher individual perception of autonomy supports from both supervisor and work environment is, the higher is individual perception of procedural justice and interpersonal justice. This result implicates that supervisor should build perception of autonomy support among individuals in organization by buiding trust culture, open communication culture, supportive culture to increase the individual perception of procedural and interpersonal justice.

Communication elements supporting patient safety in psychiatric inpatient care.

Communication is important for safe and quality health care. The study provides needed insight on the communication elements that support patient safety from the psychiatric care view. Fluent information transfer between the health care professionals and care units is important for care planning and maintaining practices. Information should be documented and implemented accordingly. Communication should happen in an open communication culture that enables discussion, the opportunity to have debriefing discussions and the entire staff can feel they are heard. For effective communication, it is also important that staff are active themselves in information collecting about the essential information needed in patient care. In mental health nursing, it is important to pay attention to all elements of communication and to develop processes concerning communication in multidisciplinary teams and across unit boundaries. The study aims to describe which communication elements support patient safety in psychiatric inpatient care from the viewpoint of the nursing staff. Communication is an essential part of care and one of the core competencies of the psychiatric care. It enables safe and quality patient care. Errors in health care are often connected with poor communication. The study brings needed insight from the psychiatric care view to the topic. The data were gathered from semi-structured interviews in which 26 nurses were asked to describe the elements that constitute patient safety in psychiatric inpatient care. The data were analysed inductively from the viewpoint of communication. The descriptions connected with communication formed a main category of communication elements that support patient safety; this main category was made up of three subcategories: fluent information transfer, open communication culture and being active in information collecting. Fluent information transfer consists of the practical implementation of communication; open communication culture is connected with the cultural issues of communication; and being active in information collecting is related to a nurse's personal working style, which affects communication. It is important to pay attention to all the three areas and use this knowledge in developing patient safety practices and strategies where communication aspect and culture are noted and developed. In mental health nursing, it is important to develop processes concerning communication in multidisciplinary teams and across unit boundaries.

The Culture of Incident Reporting and Feedback: A Cross-Sectional Study in a Hospital Setting

A safety culture where incidents have been reported and feedback given is essential to detect and understand system failures. The aims of this study were to examine the culture of incident reporting and feedback (the incident culture) in a hospital setting, and the associations between the incident culture and other dimensions of the safety culture. A cross-sectional study was carried out with the instrument Hospital Survey on Patient Safety Culture (HSOPSC) within 16 units in six somatic hospitals at a Norwegian Hospital Trust. Units with identical specialities across the hospitals constitute a clinic. HSOPSC measures the health care personnel’s perception of the safety culture, seven safety dimensions at the unit level, three at the hospital level and four outcome measures. The outcome measures “Frequency of event reporting” and the dimension “Feedback and communication about error” were combined into the variable “incident culture”, score 1 - 5. A positive score was defined as ≥ 4.0. This study included 631 health care personnel. The mean score for the incident culture was 3.10 (SD 0.65) with significant differences between the clinics, and the hospitals. The strongest predictors for the incident culture were the dimensions “Communication openness” (linear regression slope B 0.470; 95% CI 0.398 to 0.543; p < 0.001), “Manager expectations and actions promoting safety” (B 0.378; 95% CI 0.304 to 0.453; p < 0.001), “Organisational learning and continuous improvement” (B 0.374; 95% CI 0.293 to 0.455; p < 0.001) and “Teamwork across hospital units” (B 0.360; 95% CI 0.261 to 0.459; p < 0.001). In this study, the incident culture needed improvements. To improve the incident culture, the attention may be directed towards developing and maintaining a culture of open communication, management that promotes safety, and a learning organisation and teamwork between the units.

Patient safety and engagement at the frontlines of healthcare.

Since the release of the seminal work To Err Is Human in 1999, there has been widespread acknowledgement of the need to change our approach to patient safety in North America. Specifically, healthcare organizations must adopt a systems approach to patient safety, in which organizations take a comprehensive approach aimed at building resilient barriers and ensuring a culture of open communication and learning. Here in Canada, the patient safety movement gained momentum following the publication of the Canadian Adverse Events Study in 2004, which concluded that close to 40% of all hospital-associated adverse events were potentially preventable. Baker et al. (2004) argued for the need to modify the work environment of healthcare professionals to better ensure barriers were in place, as well as the need to improve communication and coordination among healthcare providers. The changes proposed a decade ago required greater healthcare worker engagement in patient safety and the creation of a culture of patient safety.

PO-0332 Barriers To Disclosure Of Medication Errors

Background Medication administration error is the most frequent error in paediatrics and one of the leading causes of death.Adverse event reporting is critical to improving patient safety but challenging in our field, and not without barriers. The purpose of this analysis was to determine how often medications errors get communicated to patients and/or families and to identify the barriers perceived by healthcare providers to disclose these errors. Methods A survey was distributed to the critical care team. The questions were answered anonymously, with the only identifier being their position in the critical care team. Results A 76% response was obtained, eight attendings (44.4%), 5 nurses-RNs (27.8%), 3 nurse practitioners- NPs (16.7%), and 3 fellows (16.7%) returned the survey. The group that ‘always’ reported communication of medicine errors was the attendings (42%), followed by RNs (40%), NPs (25%), and the fellows (0%) (Figure 1). The most often perceived obstacle to communicating was family not being available (Figure 2). Conclusion This analysis demonstrated that communication of medication errors does not happen consistently. In addition, the most common obstacle identified was the absence of family when the event occurs. This is most likely a challenge that is more unique to the paediatric population. The culture of open communication is critical in creating a safer medical environment; therefore, it is a skill that must be implemented into the medical education.

Leadership and innovation in nursing seen through a historical lens

To explore nurses' archived accounts of Matron Muriel Powell's management and leadership style and the impact of this on the implementation and sustainability of innovation in the workplace. In popular discourse, the matron has become an emblem of leadership. Although the title disappeared in the UK in the late 1960s as part of the re-organization recommended by the Salmon Report, it re-appeared in 2002 in an attempt to improve care standards by reasserting a strong nursing presence and clinical leadership role. Secondary data analysis using qualitative thematic analysis. This paper draws on interview data held in the 'Nurses Voices' archive. The interview transcripts of 132 nurses who trained or worked at St George's hospital in 1920-1980 were analysed in depth between March 2011-January 2012 and themes were generated inductively by grouping together emergent codes in the data with similar meaning. Looking back, the nurses recalled strong memories of the leadership of Matron Powell. Her presence emerged as a significant influence throughout the interviews. Two resonant themes were identified: innovation and open communication. Through her visibility and direct access with patients and staff, Dame Muriel Powell showed what we would now call transformative leadership qualities. Her leadership created a culture of open communication and innovation that initiated change in the organization and the nursing workforce. Looking back and learning from historical figures can deepen understanding and provide pointers for the nurse leaders of today.

Der Schnellschnitt in der Neuropathologie

Neuropathological evaluation of frozen sections requires a) special expertise in neuropathological specimen assessment and neurooncology as well as b) a trustful and open communication culture with the neurosurgeons. In addition to frozen sections, cytological examinations of smear and touch preparations as supporting methods are available to reach a correct diagnosis: these additional methods should therefore be performed whenever possible. Besides evaluation of biopsy specimens, appraisal of resection specimens and resection margin controls are of high clinical relevance. In the case of diffusely infiltrating central nervous system (CNS) neoplasms, in particular gliomas, resection margin control is often not feasible in contrast to other types of solid tumor.

Information Technology and Process Performance: An Empirical Investigation of the Interaction Between IT and Non‐IT Resources*

ABSTRACTDrawing on the resource‐based view, we propose a configurational perspective of how information technology (IT) assets and capabilities affect firm performance. Our premise is that IT assets and IT managerial capabilities are components in organizational design, and as such, their impact can only be understood by taking into consideration the interactions between those IT assets and capabilities and other non‐IT components. We develop and test a model that assesses the impact of explicit and tacit IT resources by examining their interactions with two non‐IT resources (open communication and business work practices). Our analysis of data collected from a sample of firms in the third‐party logistics industry supports the proposed configurational perspective, showing that IT resources can either enhance (complement) or suppress (by substituting for) the effects of non‐IT resources on process performance. More specifically, we find evidence of complementarities between shared business–IT knowledge and business work practice and between the scope of IT applications and an open communication culture in affecting the performance of the customer‐service process; but there is evidence of substitutability between shared knowledge and open communications. For decision making, our results reinforce the need to account for all dimensions of possible interaction between IT and non‐IT resources when evaluating IT investments.

Integration or co-optation? Traditional knowledge and science in the Alaska Beluga Whale Committee

Traditional ecological knowledge (TEK) has become a focus of increasing attention by natural resource managers over the past decade, particularly in the context of the shared management authority between resource users and government agencies (co-management). Little work has been done on how TEK can be successfully integrated with science and applied in contemporary science-based resource management institutions, and the efficacy and legitimacy of co-management and associated attempts to document TEK or integrate it with science have recently been questioned. The cooperative research programme of one co-management group, the Alaska Beluga Whale Committee (ABWC), was studied to describe how TEK and science are integrated and applied in the research process, document perceptions and attitudes of native hunters and scientists towards TEK and science, and identify organizational characteristics that facilitate knowledge integration. Hunters and TEK played a variety of roles in ABWC's research programme, including hypothesis generation, sample collection and data interpretation. Hunters and scientists defined TEK similarly, but differed in their views of science, which hunters often perceived as a tool of state control. Despite political undercurrents, the ABWC displayed several indicators of successful knowledge integration. Organizational characteristics that facilitated integration included a membership structure fostering genuine power-sharing and a range of opportunities for formal and informal interactions among hunters and scientists leading to long-term relationships and an organizational culture of open communication and transparency in decision-making. Given the importance of long-term relationships between scientists and hunters for successful knowledge integration, this study raises questions about (1) the potential for meaningful integration in short-term projects such as environmental impact assessment and (2) the use of TEK documentation studies in the absence of other forms of active participation by TEK- holders.

Crew Resource Management

Healthcare organizations continue their struggle to establish a culture of open communication and collaboration. Lessons are learned from the aviation industry, which long ago acknowledged that most errors were the result of poor communication and coordination rather than individual mistakes. The author presents a review of how some healthcare organizations have successfully adopted aviation's curriculum called Crew Resource Management, which promotes and reinforces the conscious, learned team behaviors of cooperation, coordination, and sharing.