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Improving Employee Voice About Transgressive or Disruptive Behavior

Overview of attention for article published in Academic medicine, April 2019
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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 (#47 of 4,583)
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (98th percentile)

Mentioned by

news
4 news outlets
blogs
1 blog
twitter
142 tweeters

Citations

dimensions_citation
4 Dimensions

Readers on

mendeley
22 Mendeley
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Title
Improving Employee Voice About Transgressive or Disruptive Behavior
Published in
Academic medicine, April 2019
DOI 10.1097/acm.0000000000002447
Pubmed ID
Authors

Mary Dixon-Woods, Anne Campbell, Graham Martin, Janet Willars, Carolyn Tarrant, Emma-Louise Aveling, Kathleen Sutcliffe, Janice Clements, Michelle Carlstrom, Peter Pronovost

Abstract

Employee voice plays an important role in organizational intelligence about patient safety hazards and other influences on quality of patient care. The authors report a case study of an academic medical center that aimed to understand barriers to voice and make improvements in identifying and responding to transgressive or disruptive behaviors. The case study focuses on an improvement effort at Johns Hopkins Medicine that sought to improve employee voice using a two-phase approach of diagnosis and intervention. Confidential interviews with 67 individuals (20 senior leaders, 47 frontline personnel) were conducted during 2014 to diagnose causes of employee reluctance to give voice about behavioral concerns. A structured intervention program to encourage voice was implemented, 2014-2016, in response to the findings. The diagnostic interviews identified gaps between espoused policies of encouraging employee voice and what happened in practice. A culture of fear pervaded the organization that, together with widespread perceptions of futility, inhibited personnel from speaking up about concerns. The intervention phase involved four actions: sharing the interview findings; coordinating and formalizing mechanisms for identifying and dealing with disruptive behavior; training leaders in encouraging voice; and building capacity for difficult conversations. The problems of giving voice are widely known across the organizational literature, but difficult to address. This case study offers an approach that includes diagnostic and intervention phases that may be helpful in remaking norms, facilitating employee voice, and improving organizational response. It highlights specific actions that are available for other organizations to adapt and test.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Twitter Demographics

The data shown below were collected from the profiles of 142 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 22 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 22 100%

Demographic breakdown

Readers by professional status Count As %
Unspecified 4 18%
Researcher 4 18%
Other 3 14%
Student > Bachelor 3 14%
Student > Master 2 9%
Other 6 27%
Readers by discipline Count As %
Medicine and Dentistry 10 45%
Unspecified 7 32%
Psychology 2 9%
Biochemistry, Genetics and Molecular Biology 1 5%
Social Sciences 1 5%
Other 1 5%

Attention Score in Context

This research output has an Altmetric Attention Score of 126. 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 16 October 2019.
All research outputs
#124,256
of 13,762,857 outputs
Outputs from Academic medicine
#47
of 4,583 outputs
Outputs of similar age
#4,179
of 221,351 outputs
Outputs of similar age from Academic medicine
#1
of 75 outputs
Altmetric has tracked 13,762,857 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 4,583 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.9. This one has done particularly well, scoring higher than 98% 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 221,351 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 75 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 98% of its contemporaries.