SynthesisBMC health services research2024
Classification of influencing factors of speaking-up behaviour in hospitals: a systematic review.
Synthesis in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Workplace Violence in Indonesian Clinical Learning Environments: Cultural and Organisational Contexts Shaping Nursing Students' Experiences.Nursing inquiry · 2026Article
- 'If You Don't Speak Up, It Will Eat You Up': A Critical Discourse Analysis of Voice and Silence in a Multicultural Clinical Healthcare System.Nursing inquiry · 2026Article
- Informal peer diagnostic second opinion: Hospitalist practices and perspectives.Journal of hospital medicine · 2026Article
- Speaking up or staying silent? Confidence, barriers and institutional readiness among Syrian medical and dental students: a cross-sectional survey.BMC medical education · 2026Article
- Communication failure during operating room turnover: a HFACS-informed qualitative case study of system-level coordination.BMC health services research · 2026Article
- "We learn while doing": informal training experiences of critical care nurses managing dialysis technologies in intensive care units.BMC nursing · 2026Article
- Organising Nurse Work Environments: (Reshaped) Roles of Nursing Teams-A Qualitative Descriptive Study.Journal of advanced nursing · 2026Article
- Education that Empowers: A critical realist evaluation of a novel incivility-focused immersive simulation.Advances in simulation (London, England) · 2026Article
- The ideal-reality gap: a qualitative study of nurse middle managers' perspectives on speaking up for patient safety.Frontiers in public health · 2026Article
- Putting patients first: how risk awareness drives action among healthcare professionals in Slovakia.Frontiers in psychology · 2026Article
- Conflict resolution strategies and their association with perceived stress among German medical students: a cross-sectional study.Frontiers in medicine · 2026Article
- Workplace loneliness and the communication climate of healthcare workers: the moderating role of perceived social competence.BMC health services research · 2025Article
- Roles and responsibilities of registered nurses in the early recognition and management of sepsis in acute hospital settings: a scoping review.BMJ open quality · 2025Article
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSpeaking up among healthcare professionals plays an essential role in improving patient safety and quality of care, yet it remains complex and multifaceted behaviour. Despite awareness of potential risks and adverse outcomes for patients, professionals often hesitate to voice concerns due to various influencing factors. This complexity has encouraged research into the determinants of speaking-up behaviour in hospital settings. This review synthesises these factors into a multi-layered framework. It aims to provide a more comprehensive perspective on the influencing factors, which provides guidance for interventions aimed at fostering environments contributing to speaking up in hospitals.
methodsA systematic review was conducted in November 2024, searching databases: PubMed, Scopus and Web of Science. Following PRISMA guidelines and the three stages for thematic synthesis, we developed the classification of influencing factors. Out of 1,735 articles identified articles, 413 duplicates were removed, 1,322 titles and abstracts were screened, and 152 full texts (plus six additional articles) were assessed. Ultimately, 45 articles met the inclusion criteria.
resultsThe review categorised influencing factors into four categories: individual (29 articles, 64%), relational (21 articles, 47%), contextual (19 articles, 42%), and organisational (26 articles, 58%). These categories encompass motivating, hindering and trade-off factors affecting speaking up among healthcare professionals in hospitals.
conclusionsThe multi-layered framework highlights the dynamic interplay of factors influencing speaking up among healthcare professionals. A systems approach is essential for identifying barriers and enablers and designing effective speaking up interventions. This framework serves as a foundation for more focused research and practical guidance, enabling healthcare leaders to address barriers across all categories. By fostering environments that support open communication, organisations can enhance patient safety and quality of care.
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