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In a national study, 84% of physicians and 62% of nurses and other clinical caregivers said they've seen co-workers taking potentially dangerous shortcuts-but less than 10% confront their colleagues with their concerns. Called "Silence Kills: The Seven Crucial Conversations for Healthcare," the study focused on how communication problems in hospitals affect patient safety.
Researchers collected survey data from 1,143 nurses, 106 physicians, 266 clinical care staff, and 175 administrators during 2004. They identified seven essential "categories of conversations" that health care professionals must master, yet find difficult to address: broken rules, mistakes, lack of support, incompetence, poor teamwork, disrespect, and micromanagement. Respondents were asked to indicate the percentage of their co-workers with whom they had concerns in these categories.
Among the findings:
* 48% of nurses and clinical care providers and 88% of physicians said they work with some colleagues who show poor clinical judgment.
* 52% of nurses and clinical care providers work with some people who abuse their authority.
* 23% of nurses say they're considering leaving their unit because of their concerns.
* Although fewer than 10% of health care workers spoke up about their concerns, those who did said they felt good about it, observed better patient outcomes, and were more satisfied with their work.
For more on the report, which was cosponsored by the American Association of Critical-Care Nurses and the VitalSmarts consulting group, visit http://www.rxforbettercare.org.
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