The flip side of speaking up: a new model to facilitate positive responses to speaking up in the operating theatre.

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dc.contributor.author Long, Jennifer
dc.contributor.author Jowsey, Tanisha
dc.contributor.author Garden, Alexander
dc.contributor.author Henderson, Kaylene
dc.contributor.author Weller, Jennifer
dc.date.accessioned 2020-12-09T00:58:40Z
dc.date.available 2020-12-09T00:58:40Z
dc.date.issued 2020-9-14
dc.identifier.issn 0007-0912
dc.identifier.uri http://hdl.handle.net/2292/53955
dc.description.abstract BACKGROUND:Speaking up is important for patient safety, but only if the concern raised is acknowledged and responded to appropriately. While the power to change the course of events rests with those in charge, research has focussed on supporting those in subordinate positions to speak up. We propose responsibility also rests with senior clinical staff to respond appropriately. We explored the perceptions of senior staff on being spoken up to in the operating theatre (OT), and factors moderating their response. METHODS:We undertook interviews and focus groups of fully qualified surgeons, anaesthetists, nurses, and anaesthetic technicians working in OTs across New Zealand. We used grounded theory to analyse and interpret the data. RESULTS:With data from 79 participants, we conceptualise three phases in the speaking up interaction: 1) the content of the speaker's message and the tone of delivery; 2) the message interpreted through the receiver's filters, including beliefs on personal fallibility and leadership, respect for the speaker, understanding the challenges of speaking up, and personal cultural and professional norms around communication; and 3) the receiver's subsequent response and its effects on the speaker, the observing OT staff, and patient care. CONCLUSIONS:The speaking up interaction can be high stakes for the whole OT team. The receiver response can strengthen team cohesion and function, or cause distress and tension. Our grounded theory uncovers multiple influences on this interaction, with potential for re-framing and optimising the speaker/receiver interaction to improve team function and patient safety.
dc.format.medium Print-Electronic
dc.language eng
dc.publisher Elsevier BV
dc.relation.ispartofseries British journal of anaesthesia
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm
dc.subject 1103 Clinical Sciences
dc.title The flip side of speaking up: a new model to facilitate positive responses to speaking up in the operating theatre.
dc.type Journal Article
dc.identifier.doi 10.1016/j.bja.2020.08.025
dc.date.updated 2020-11-19T01:39:08Z
dc.rights.holder Copyright: The author en
pubs.publication-status Published
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Journal Article
pubs.elements-id 816958
dc.identifier.eissn 1471-6771


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