Exploring the Impact of Personal, Emotional, and Relational Elements That Influence the Decision to Speak Up During Critical Safety Moments

Kelly Rabah, Wright State University


This qualitative study focused on exploring the relationships between personal, emotional, and relational elements and the decision to speak up during critical safety moments. A phenomenological single site case study was employed using semi structured interviews to examine the healthcare professionals’ stories. The participants shared their lived experiences when making the choice to speak up or not, and the consequences – positive and negative, for themselves, their patients, and the organization. Results showed the decision to speak up is complex. There are many components that influence the decision to raise voice in the face of known risk. Personal elements, including sense of competence and psychological safety, relational elements including team trust, and emotional elements - especially fear, anger, and anticipatory regret, play a role. Findings include implications for leaders to implement modeling and principles of transformational leadership to proactively create a culture where raising voice is not only accepted but expected.