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PSNet: Patient Safety Network
Journal Article

Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety.

Szymczak JE. Sociology of health & illness. 2016;38:325-39.

This qualitative study analyzed how clinicians decide to speak up if they observe a safety breach (in this case, failing to follow infection control precautions). Although several factors influence this decision, the overarching conclusion is that the decision to speak up is strongly influenced by the context and immediate circumstances surrounding the incident in question. The willingness to speak up about safety concerns is a core component of safety culture.