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„Speaking Up“ statt tödlichem Schweigen im Krankenhaus

Die entscheidende Rolle der Gruppenprozesse und Organisationskultur

Speaking Up instead of deadly silence in hospitals

The importance of group processes and organisation culture

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Gruppe. Interaktion. Organisation. Zeitschrift für Angewandte Organisationspsychologie (GIO) Aims and scope Submit manuscript

Zusammenfassung

In diesem Artikel beschreiben wir die Relevanz des Schweigens vs. Speaking Up für die Patientenbehandlung im Krankenhaus. Schweigen bedeutet, absichtlich potentiell wichtige Informationen, Bedenken, Vorschläge oder Fragen zurückzuhalten. Das erwünschte Gegenteil des Schweigens ist Speaking Up – das absichtliche Äussern einer Idee, einer persönlichen Meinung oder Sorge und das Nachfragen bei Zweifeln – in der Regel gegenüber Vorgesetzten, aber auch gegenüber Kollegen/-innen. Speaking Up dient nicht nur der Prävention und schnellen Behebung von Fehlern, z. B. durch aufmerksam Machen und Nachfragen. Es ermöglicht auch das Zusammenarbeiten im hochkomplexen Arbeitsfeld Krankenhaus und ist ein zentrales Element organisationalen Lernens. Problematisch ist, dass in Krankenhäusern das Schweigen im Vergleich zu Speaking Up überwiegt. Wir erläutern anhand des aktuellen Forschungsstandes, dass die Gründe für Schweigen im Klima und in den sozialen Interaktionsprozessen der Gruppen und Organisationen anstatt in fehlender Motivation oder persönlicher Inkompetenz zum Speaking Up liegen. Basierend auf paradoxen Interventionen geben wir sowohl paradoxe Ratschläge – scherzhafte, kurzweilige und nicht ernstgemeinte Empfehlungen für ungewolltes Schweigen anstatt Speaking Up, als auch Speaking Up-begünstigende Handlungsempfehlungen.

Abstract

We describe the importance of silence versus speaking up for patient care. Silence is defined as intentionally withholding work-related ideas, information, and opinions. Speaking up or voice is defined as intentionally expressing work-related ideas, information, and opinions. Speaking up is not only important for error prevention and correction in healthcare. It also allows for working together in highly diverse teams in complex clinical settings in hospitals and is a core element of organizational learning. However, speaking up is rare in hospitals. Based on recent literature we describe that the scarcity of speaking up is due to organizational climates and group interaction processes rather than to lack of individual skill or motivation to speak up. In addition to provide speaking up-enabling ideas, using the concept of organizational paradoxes we provide paradoxical recommendations as humorous and unserious tips for increasing undesired silence.

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Abb. 1

Notes

  1. Das Team-Time-Out ist ein von der Weltgesundheitsorganisation (WHO) vorgeschlagenes Vorgehen, bei dem alle an der Operation beteiligten Personen vor Operationsbeginn verbal eine Checkliste durcharbeiten, in der alle wichtigen Behandlungsstandards für den/die Patienten/-in enthalten sind (z. B. Identität des/der Patienten/-in, bekannte Allergien des/der Patienten/-in, Namen und Rollen aller Teammitglieder & erwartete Komplikationen, World Health Organization 2009).

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  1. Simulationszentrum, Universitätsspital Zürich, Rämistrasse 100, 8091, Zürich, Schweiz

    Michaela Kolbe

  2. Simulationszentrum, Institut für Anästhesiologie, Universitätsspital Zürich, Rämistrasse 100, 8091, Zürich, Schweiz

    Bastian Grande

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Kolbe, M., Grande, B. „Speaking Up“ statt tödlichem Schweigen im Krankenhaus. Gr Interakt Org 47, 299–311 (2016). https://doi.org/10.1007/s11612-016-0343-5

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