Interprofessional model on speaking up behaviour in healthcare professionals: a qualitative study.
Organizational culture can influence willingness to speak up about patient safety concerns. Based on focus groups and interviews with nurses, advanced practice providers, and physicians, this study found that the hierarchical culture of medicine presents a barrier to speaking up about safety concerns, but that certain factors (institutional, interpersonal, and individual) can modulate the impact of hierarchy. Interventions to promote speaking up behaviors should focus on engaging leaders across the institution and within the hierarchy.