Sally Nathan, Jeffrey Braithwaite and Niamh Stephenson
– The purpose of this paper is to examine the views of community representatives participating in a large health service in Australia.
Abstract
Purpose
The purpose of this paper is to examine the views of community representatives participating in a large health service in Australia.
Design/methodology/approach
Cross-sectional survey of 49 community representatives and interviews with a purposeful sample of representatives (n=10) and staff (n=19).
Findings
Most community representatives had positive attitudes about their value and potential for influence, citing concrete examples of impact. Having an external network or group was related to their beliefs in their ability to add value to their health service. Community representatives largely agreed they provided a link to, and represented, the wider community although most thought staff did not understand their role or how to work with them. Some staff questioned representativeness of their community representatives.
Practical implications
Improving community participation is argued to be important in delivering better healthcare services, but effective engagement and representation at the local level is often challenging. Focusing on community representative views takes us beyond debates around representativeness to identify practical strategies to improve practice. The authors recommend health services recruit consumers with strong links to networks in the community, provide a structured and supported program, and improve staff understanding of the range of possible roles for community representatives. Local examples of community representatives’ impact on policy and practice should be widely communicated.
Originality/value
In giving prominence to the views of consumers using triangulated methods, the authors found most could report with clarity what their role was and how they impacted at their local health service.
Details
Keywords
Jennifer Creese, John-Paul Byrne, Anne Matthews, Aoife M. McDermott, Edel Conway and Niamh Humphries
Workplace silence impedes productivity, job satisfaction and retention, key issues for the hospital workforce worldwide. It can have a negative effect on patient outcomes and…
Abstract
Purpose
Workplace silence impedes productivity, job satisfaction and retention, key issues for the hospital workforce worldwide. It can have a negative effect on patient outcomes and safety and human resources in healthcare organisations. This study aims to examine factors that influence workplace silence among hospital doctors in Ireland.
Design/methodology/approach
A national, cross-sectional, online survey of hospital doctors in Ireland was conducted in October–November 2019; 1,070 hospital doctors responded. This paper focuses on responses to the question “If you had concerns about your working conditions, would you raise them?”. In total, 227 hospital doctor respondents (25%) stated that they would not raise concerns about their working conditions. Qualitative thematic analysis was carried out on free-text responses to explore why these doctors choose to opt for silence regarding their working conditions.
Findings
Reputational risk, lack of energy and time, a perceived inability to effect change and cultural norms all discourage doctors from raising concerns about working conditions. Apathy arose as change to working conditions was perceived as highly unlikely. In turn, this had scope to lead to neglect and exit. Voice was seen as risky for some respondents, who feared that complaining could damage their career prospects and workplace relationships.
Originality/value
This study highlights the systemic, cultural and practical issues that pressure hospital doctors in Ireland to opt for silence around working conditions. It adds to the literature on workplace silence and voice within the medical profession and provides a framework for comparative analysis of doctors' silence and voice in other settings.