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Systems and culture
Enhancing voice in healthcare organisations
Background
Staff from many different types of organisation have insights into the day-to-day challenges in their workplace and ideas about how to improve the quality of their services, but healthcare organisations are often not very good at listening to them and using their insights for improvement. When staff do share their concerns or ideas, healthcare organisations can find it hard to acti on them effectively.
The Enhancing Voice in Healthcare Organisations project will examine the entire ‘voice pathway’ – the process from when an employee raises an initial idea or concern to its eventual impact on the organisation, if any. The study will cover the ways staff identify and raise concerns, how others hear and respond to them, and how organisations act on them.
The project also aims to develop a framework for ‘voice stewardship’, helping organisations to treat staff voice as a valuable asset for improvement. The focus of the study is not limited to the conditions that might encourage staff to speak up in the first place, but also covers what happens next when others respond (or fail to respond) and organisations act (or fail to act).
By looking at the entire voice pathway, this study will provide practical and usable results including development of a framework and targeted interventions that can be used to enhance voice stewardship.
Approach
This project will use a mixed methods approach that includes:
- Stakeholder interviews to explore the issues currently affecting how voice is used in healthcare, including any challenges, and examples of innovative practice.
- Video vignettes, shared with a diverse range of NHS staff, which will examine whether and how responses vary depending on who raises a concern and what it’s about.
- Case studies exploring how voice pathways and voice stewardship work within organisations with an emphasis on what good practice looks like and how it can be shared.
- Co-design of a voice stewardship framework and interventions that might address challenges across the voice pathway, ready for using, adjusting, or testing further.
Throughout the project, we will be guided by an expert collaborative group that includes:
- people with experience of speaking up,
- people responsible for systems that respond to voice locally and nationally,
- representatives of national bodies, and
- patients and the public.
We hope to learn from good practice in healthcare and other fields to develop practical ways for organisations to make better use of voice and support staff when they speak up.
Project team
AJ
Aled Jones
University of Plymouth
WL
Will Lea
Yorkshire and Humber Patient Safety Research Collaboration
RM
Russell Mannion
University of Birmingham
Funding and ethics
The National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research (HSDR) programme are funding this project, reference number NIHR167501
