Interventions promoting employee “speaking-up” within healthcare workplaces: A systematic narrative review of the international literature

Healthcare systems worldwide increasingly value the contribution of employee voice in ensuring quality patient care. Although employees’ concerns are often dealt with satisfactorily, considerable evidence suggests that some employees may feel unable to speak-up, and even when they do their be ignored. As a result, addition trans-national national policies, workplace interventions support speak-up about have recently increased. A systematic narrative review, informed by complex perspectives addresses question: “What strategies and/or been implemented promote speaking-up employees”? Thirty-four studies were included review. Most reported inconclusive results. Researchers explanations for successful implementation, or otherwise, synthesised into two themes (Braithwaite et al., 2018 (a)) hierarchical, interdisciplinary cultural relationships (Francis, 2015 (b)) psychological safety. We strengthen existing base providing an in-depth critique system factors influencing implementation within healthcare workforce. many locally unique, there international similarities cultures norms created contexts inimical interventions. Changing communication behaviours creating climate supports is immensely challenging. Interventions can usurped practice complex, emergent contextual issues, such as pre-existing socio-cultural hierarchies.