Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations

Document Type: Editorial

Authors

1 Health Services Management Centre, University of Birmingham, Birmingham, UK

2 School of Management, University of St Andrews, Fife, UK

Abstract

‘Whistleblowing’ has come to increased prominence in many health systems as a means of identifying and addressing quality and safety issues. But whistleblowing – and the reactions to it – have many complex and ambiguous aspects that need to be considered as part of the broader (organisational) cultural dynamics of healthcare institutions.

Highlights

Commentaries Published on this Paper

  • Whistleblowing Need not Occur if Internal Voices Are Heard: From Deaf Effect to Hearer Courage; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

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  • Whistleblowing: Don’t Encourage It, Prevent It; Comment on “Cultures of Silence And Cultures of Voice: The Role Of Whistleblowing in Healthcare Organisations”

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  • What Makes Whistleblowers So Threatening?; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

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  • What About Leadership?; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

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  • A Wicked Problem? Whistleblowing in Healthcare Organisations; Comment on “Cultures of Silence And Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

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  • When Whistle-blowers Become the Story: The Problem of the ‘Third Victim’; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

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  • The Role of Employee Whistleblowing and Raising Concerns in an Organizational Learning Culture – Elusive and Laudable?; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

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  • Whistle Blowing: A Message to Leaders and Managers; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organizations”

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Authors’ Response to the Commentaries

  • Whistleblowing in the Wind Towards a Socially Situated Research Agenda: A Response to Recent Commentaries

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Keywords

Main Subjects


  1. Braithwaite J, Matsuyama Y, Mannion R, Johnson J. Healthcare Reform, Quality and Safety: Perspectives, Partnerships and Prospects in 30 Countries. Burlington, USA: Ashgate; 2015.
  2. Francis R. The Mid Staffordshire NHS Foundation Trust Public Inquiry (Chaired by Robert Francis QC) Report of the Mid Staffordshire NHS Foundation Trust. London: HSMO; 2013.
  3. Ohnishi R, Hayama Y, Kosugis S. An analysis of patient right violations in psychiatric hospitals in Japan after the enactment of the Mental Health Care act of 1987. Issues Ment Health Nurs. 2008;29(12):1290-1303. doi:10.1080/01612840802498417
  4. Shearer B, Marshall, S Buist M, et al. What stops hospital clinical staff from following protocols? An analysis of the incidents and factors behind the failure of bedside clinical staff to initiate the rapid response system in a multi-campus Australian metropolitan healthcare service. BMJ Qual Saf. 2012;21(7):569-575. doi:10.1136/bmjqs-2011-000692
  5. Francis R. Freedom to Speak Up: An Independent Review into Creating an Open and Honest Reporting Culture in the NHS. London: The Stationery Office; 2014.
  6. NHS Staff Survey (NSS) 2012. London: Department of Health; 2012.
  7. Medical Protection Society (MPS). Whistleblowing doctors afraid to speak out. London: MPS; 2012.
  8. Jones  A,  Kelly D. Whistle-blowing and workplace culture in older peoples' care: qualitative insights from the healthcare and social care workforce. Sociol Health Illn. 2014;36:986-1002. doi:10.1111/1467-9566.12137
  9. Blenkinsopp J, Edwards MS. On not blowing the whistle: quiescent silence as anemotion episode. In: Zerbe WJ, Härtel CE, Ashkanasy NM,  eds. Emotions, Ethics, and Decision-making. Bingley, United Kingdom: Emerald Group Publishing; 2008:181-206.
  10. Kelly D, Jones A. When care is needed: the role of whisteblowing in promoting best standards from an individual and organizational perspective. Qual Ageing Older Adults. 2013;14(3:80-191. doi:10.1108/QAOA-05-2013-0010
  11. Henriksen K, Dayton E. Organisational silence and threats to patient safety. Health Serv Res 2006;41(4):1539-1554. doi:10.1111/j.1475-6773.2006.00564.x
  12. Cueller M. An investigation of the Deaf effect response to bad news reporting in information systems projects. Georgia State University. Accessed May 10. 2015. Published 2009.
  13. Davies HT, Mannion R. Will prescriptions for cultural change improve the NHS? BMJ. 2013;346:f15. doi:10.1136/bmj.f1305
  14. Mannion R, Thompson C. Systematic biases in group decision-making: implications for patient safety. Int J Qual Health Care. 2014;26(6):606-612. doi:10.1093/intqhc/mzu083
  15. Mannion R, Davies H, Marshall M. Cultures for Performance in Healthcare, Buckingham: Open University Press; 2005.
  16. Mannion R, Davies H, Marshall M. Cultural attributes of 'high' and 'low' performing hospitals. J Health Organ Manag 2005;19(6):431-439. doi:10.1108/14777260510629689