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Making soft intelligence hard: a multi-site qualitative study of challenges relating to voice about safety concerns

Overview of attention for article published in BMJ Quality & Safety, February 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#44 of 1,400)
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

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306 tweeters
facebook
1 Facebook page

Citations

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14 Dimensions

Readers on

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47 Mendeley
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Title
Making soft intelligence hard: a multi-site qualitative study of challenges relating to voice about safety concerns
Published in
BMJ Quality & Safety, February 2018
DOI 10.1136/bmjqs-2017-007579
Pubmed ID
Authors

Graham P Martin, Emma-Louise Aveling, Anne Campbell, Carolyn Tarrant, Peter J Pronovost, Imogen Mitchell, Christian Dankers, David Bates, Mary Dixon-Woods

Abstract

Healthcare organisations often fail to harvest and make use of the 'soft intelligence' about safety and quality concerns held by their own personnel. We aimed to examine the role of formal channels in encouraging or inhibiting employee voice about concerns. Qualitative study involving personnel from three academic hospitals in two countries. Interviews were conducted with 165 participants from a wide range of occupational and professional backgrounds, including senior leaders and those from the sharp end of care. Data analysis was based on the constant comparative method. Leaders reported that they valued employee voice; they identified formal organisational channels as a key route for the expression of concerns by employees. Formal channels and processes were designed to ensure fairness, account for all available evidence and achieve appropriate resolution. When processed through these formal systems, concerns were destined to become evidenced, formal and tractable to organisational intervention. But the way these systems operated meant that some concerns were never voiced. Participants were anxious about having to process their suspicions and concerns into hard evidentiary facts, and they feared being drawn into official procedures designed to allocate consequence. Anxiety about evidence and process was particularly relevant when the intelligence was especially 'soft'-feelings or intuitions that were difficult to resolve into a coherent, compelling reconstruction of an incident or concern. Efforts to make soft intelligence hard thus risked creating 'forbidden knowledge': dangerous to know or share. The legal and bureaucratic considerations that govern formal channels for the voicing of concerns may, perversely, inhibit staff from speaking up. Leaders responsible for quality and safety should consider complementing formal mechanisms with alternative, informal opportunities for listening to concerns.

Twitter Demographics

The data shown below were collected from the profiles of 306 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 47 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 10 21%
Student > Ph. D. Student 10 21%
Researcher 8 17%
Student > Doctoral Student 6 13%
Unspecified 4 9%
Other 9 19%
Readers by discipline Count As %
Medicine and Dentistry 15 32%
Unspecified 7 15%
Nursing and Health Professions 6 13%
Psychology 5 11%
Social Sciences 5 11%
Other 9 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 196. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 July 2019.
All research outputs
#71,111
of 13,848,252 outputs
Outputs from BMJ Quality & Safety
#44
of 1,400 outputs
Outputs of similar age
#3,448
of 273,623 outputs
Outputs of similar age from BMJ Quality & Safety
#2
of 38 outputs
Altmetric has tracked 13,848,252 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,400 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 35.4. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 273,623 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 38 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.