24th Annual HPRCT Conference
June 19-22, 2018
Marriott Riverwalk
San Antonio, Texas
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Thursday, June 21 • 3:10pm - 4:00pm
Session Title Speak Up: Unconsciously Reinforcing the Hierarchy

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Effective sensemaking in ambiguous situations and accurate and timely feedback are essential processes of High Reliability Organizing.
The problem of people not “speaking up” during sensemaking processes and providing feedback necessary for updating persists across all industries, especially healthcare, despite interventions to promote the behavior.
“The Joint Commission predicted that 80 % of the serious safety events occur due to miscommunications among healthcare professionals. Speaking up is one of the critical behaviors of patient safety that displays an important role for improving quality and patient safety in healthcare (Ahmet Nacioglu, 2016).”
“Ineffective communication is one of the most frequently identified root causes of sentinel events and contributes to the 400,000 deaths that occur each year due to preventable medical errors (Palatnik, 2016). Ineffective communication includes failure of staff to speak up when they know something is wrong that could potentially cause harm to the patient (Palatnik, 2016).”
Despite the many initiatives implemented in the last decade encouraging staff members to speak up for patient safety, many staff are still reluctant to to speak up. There are many influencing factors cited for staff unwillingness to speak up including fear of retaliation and fear of appearing incompetent.
However, we posit that the problem is perpetuated by the current model in which the solution to the problem is to “speak up.”
Therefore we propose the new model “speak in.” This model reframes ideas related to social structures, responsibility, purpose, and meaning of speaking and shifts influencing factors in a way that will drive increased communication and improve outcomes.

avatar for Laurin Mooney

Laurin Mooney

Founder, speaking IN and Be Highly Reliable
Laurin is a nurse who has turned her focus from the heath of people to the heath of the employee experience and the critical role it plays in the modern high-risk work environment.  Convinced that High Reliability Organizing holds the keys for success in complexity she translated... Read More →
avatar for Renaldo Blocker, Ph.D.

Renaldo Blocker, Ph.D.

Associate Consultant and Assistant Professor, Mayo Clinic, Robert D. and Patricia E. Kerns Center for the Science of Health Care Delivery
Dr. Renaldo C. Blocker is an Associate Consultant and Assistant Professor in the Department of Health Sciences Research and in the Mayo Clinic Center for the Science of Health Care Delivery Healthcare Systems Engineering Department. Dr. Blocker is the Associate Scientific Director... Read More →

Thursday June 21, 2018 3:10pm - 4:00pm CDT
Salon B

Attendees (1)