Supporting health care staff to speak up about safety concerns

Being able to raise concerns is vital for patient safety, but healthcare workers are not always able to do this. Our research on speaking up in healthcare explored the nuances of speaking up and formal reporting, and barriers to voicing concerns.

This has led to the development of interventions that have proved effective in increasing the reporting of concerns by staff. Collaborative research with University Hospital Leicester aimed to support junior doctors and doctors in training to raise concerns. Research with these groups explored what stopped them from them raising concerns safely.

We worked with junior doctors to design GRIPES, a system that includes a simple online tool for anonymous reporting of minor concerns and hassles, supported by dedicated staff time to review and respond quickly to concerns.

The GRIPES tool has been highlighted as good practice by the Royal College of Physicians and has been implemented in several hospitals. It was shortlisted for an AHSN Innovation award in 2016 and was a Health Services Journal Patient Safety Awards Changing Culture finalist in 2019.

Relevant publications

• A qualitative study of speaking out about patient safety concerns in intensive care units.
• Improving employee voice about transgressive or disruptive behavior: a case study.
• Developing the ‘gripes’ tool for junior doctors to report concerns: a pilot study.