Themes, abstracted themes and participant example quotes
| Themes overarching the study findings | Themes overarching the study findings: Origins of speaking up, Organisational culture and leadership, Barriers to speaking up, Patient safety | ||
| Study areas related to research questions and propositions | Freedom To Speak Up Guardian and Confidential Contact role in an NHS trust Reflective learning organisation Patient safety and quality | ||
| Abstracted themes within the research areas | Powerful personal stories Sharing personal journey Raising own concerns Treatment of themselves and others | Moving forward: reflective learning organisation Positive steps for change and improvement Learn from past mistakes Subsequent detrimental behaviours | Local and national levels Speaking up Culture of blame Bullying, harassment, victimisation Transparency |
| Origins of speaking up: example quotes from focus group responses | ‘Historically where speaking up came from, there are several high-profile cases – Liverpool, Alder Hey, Cardiac Services. Positive or negative impact from culture & leadership.’ (Participant 2) | ‘Mid-Staffs Robert Francis, speaking up instead of whistleblowing, captured current structures of Freedom.’ (Participant 3) | |
| Barriers to speaking up: example quotes from focus group responses | ‘Appalling behaviors from senior people, juniors felt threatened.’ (Participant 2) | ‘Fear of speaking up myself and for other staff, fear of repercussions.’ (Participant 7) | ‘Cultural backgrounds and discrimination.’ (Participant 8) |
| Patient safety, staff engagement, staff health and well-being: example quotes from focus group responses | ‘Making yourself vulnerable, human existence you will fail, and how do we handle failure, need to be a reflective learning organisation.’ (Participant 3) | ‘Time, roles, prioritise.’ (Participant 4) | ‘Incident, reason more selfish, colleagues, out of my control, upsetting.’ (Participant 6) |
NHS, National Health Service.