Infections and interaction rituals in the organisation

Clinician Accounts of Speaking Up or Remaining Silent in the Face of Threats to Patient Safety

Datos Bibliográficos

ID2249073
AutoresJulia E Szymczak (0000-0002-3230-8670, Division of Infectious Diseases and The Center for Pediatric Clinical Effectiveness The Children's Hospital of Philadelphia USA, autor de correspondencia)
Año2016
Volumen38
Número2
Páginas325-339
Fecha de publicación2016-02-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaSociology of Health & Illness (JOURNAL)
Identificadores de la revistaISSN: 0141-9889 • E-ISSN: 1467-9566
EditorialWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.12371
PMID26537184
OpenAlexW2138234639
IdiomaEN
Citas recibidas15
Referencias citadas48

Clinician silence in the face of known threats to patient safety is a source of growing concern. Current explanations for the difficulties clinicians have of speaking up are conceptualised at the individual or organisational level, with little attention paid to the space between - the interaction context. Drawing on 103 interviews with clinicians at one hospital in the United States this article examines how clinicians talk about speaking up or not in the face of breaches in infection prevention technique. Accounts are analysed using a microsociological lens as stories of interaction, through which respondents appeal to situational and organisational realities of medical work that serve to justify speaking up or remaining silent. Analysis of these accounts reveals three influences on the decision to speak up, shaped by background conditions in the organisation; mutual focus of attention, interactional path dependence and the presence of an audience. These findings suggest that the decision to speak up in a clinical setting is dynamic, highly context-dependent, embedded in the interaction rituals that suffuse everyday work and constrained by organisational dynamics. This article develops a more sophisticated and distinctly sociological understanding of the reasons why speaking up in healthcare is so difficult

Aesthetics · Appeal · Context (archaeology · Face (sociological concept · Health care · Linguistics · Political science · Public relations · Silence · Situational ethics · Social science · Sociology · Space (punctuation) · Ethics in medical practice · History · Medical Malpractice and Liability Issues · Psychology · Social Psychology · Workplace Violence and Bullying