Journal of Health Organization and Management最新文献

{"title":"React, reframe and engage. Establishing a receiver mindset for more effective safety negotiations.","authors":"Melanie Barlow, Bernadette Watson, Kate Morse, Elizabeth Jones, Fiona Maccallum","doi":"10.1108/JHOM-06-2023-0171","DOIUrl":"10.1108/JHOM-06-2023-0171","url":null,"abstract":"<p><strong>Purpose: </strong>The response of the receiver to a voiced patient safety concern is frequently cited as a barrier to health professionals speaking up. The authors describe a novel Receiver Mindset Framework (RMF) to help health professionals understand the importance of their response when spoken up to.</p><p><strong>Design/methodology/approach: </strong>The framework draws on the broader receiver-focussed literature and integrates innovative findings from a series of empirical studies. These studies examined different receiver behaviour within vignettes, retrospective descriptions of real interactions and behaviour in a simulated interaction.</p><p><strong>Findings: </strong>The authors' findings indicated that speaking up is an intergroup interaction where social identities, context and speaker stance intersect, directly influencing both perceptions of and responses to the message. The authors' studies demonstrated that when spoken up to, health professionals poorly manage their emotions and ineffectively clarify the speaker's concerns. Currently, targeted training for receivers is overwhelmingly absent from speaking-up programmes. The receiver mindset framework provides an evidence-based, healthcare specific, receiver-focussed framework to inform programmes.</p><p><strong>Originality/value: </strong>Grounded in communication accommodation theory (CAT), the resulting framework shifts speaking up training from being only speaker skill focussed, to training that recognises speaking up as a mutual negotiation between the healthcare speaker and receiver. This framework provides healthcare professionals with a novel approach to use in response to speaking up that enhances their ability to listen, understand and engage in point-of-care negotiations to ensure the physical and psychological safety of patients and staff.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"ahead-of-print ahead-of-print","pages":"992-1008"},"PeriodicalIF":1.7,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41148595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivating public health emergency preparedness cooperative behaviors: based on the expectancy disconfirmation model.","authors":"Yuxiang Hong,&nbsp;Jiaqing Zhao,&nbsp;Yue Zhang,&nbsp;Qiang Su","doi":"10.1108/JHOM-09-2022-0268","DOIUrl":"10.1108/JHOM-09-2022-0268","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, the expectancy disconfirmation model (EDM) was applied to explain the formation of public health emergency preparedness cooperative behavior (EPCB) as well as considering the roles of official media exposure and positive emotions.</p><p><strong>Design/methodology/approach: </strong>The analysis was based on a sample of 374 respondents collected during the coronavirus (COVID-19) pandemic. A <i>t</i>-test was used to examine the differences in variables by sex, age and educational background. Hypothesis testing was conducted using structural equation modeling. Amos 24.0 and R 4.0.3 were used to analyze the data.</p><p><strong>Findings: </strong>The results indicated that (1) official media exposure has a positive impact on expectations for and perceived performance of public services, as well as positive emotions; (2) the EDM can be used to explain public satisfaction with government public health services; and (3) public satisfaction and positive emotions have positive effects on EPCB; (4) EDM and positive emotions mediate the relationship between official media exposure and EPCB.</p><p><strong>Originality/value: </strong>This study provides practical implications for increasing the EPCB from the perspective of risk communication.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10657422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporary healthcare services for crisis response: organization and management of a mass vaccination center.","authors":"John Ovretveit,&nbsp;Mikael Ohrling","doi":"10.1108/JHOM-12-2022-0375","DOIUrl":"https://doi.org/10.1108/JHOM-12-2022-0375","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Scientific description of the organization and management of a temporary large scale healthcare (T-LSHc) vaccination clinic and evidence-based guidance for future temporary healthcare (T-Hc) services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/methodology/approach: &lt;/strong&gt;Mixed-methods rapid feedback case study, using interviews, document analysis and quantitative data, with both data collection and analysis guided by a research-informed systems program theory of the clinic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Private contractors were not willing to bid for contracts to set up and close a T-LSHc vaccination clinic in 2022, although they had done so earlier in the year. The public health system was able successfully to set up and run the clinic itself for 2 months, serving 3,000 people a day at its peak. Part of the success was because a dedicated unit to set up and run T-Hc services had been created in 2020. The Stockholm organization model differed from the Milan model by using information technology to reduce the need for a large number of on-site doctors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research limitations/implications: &lt;/strong&gt;There may be recall bias in interview data as interviews were carried out four months after the closing of the clinic. The conclusions apply to clinically simple but managerially complex T-Hc services but are limited to public healthcare systems operating in a similar context to that of the case study service. The study contributes to the new science of healthcare crisis organization and management and fills gaps in knowledge in disaster medicine for enduring and fluctuating health crises. The findings show the importance of a capacity to establish and manage T-Hc, and of the specialist management and HIT competence that health systems will need to build to meet the crises that threaten our health, both now and in the future.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical implications: &lt;/strong&gt;Public healthcare systems can provide clinically simple and managerially complex T-Hc services quickly and successfully if they have experience and capacity to plan and set up such services, skilled operational managers respected by staff, staff who can be redeployed, and suitable health information technology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Social implications: &lt;/strong&gt;The need for healthcare services to respond to crises is likely to increase in the future. Information for creating the service may be limited at first and changing. The exact nature of the health threat may be uncertain, as may the demand and needs of subpopulations and individuals. The study findings can help to respond quickly to reduce morbidity illness and death through creating and organizing temporary large-scale public healthcare services when existing services cannot be reorganized to meet the scale of the need.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Originality/value: &lt;/strong&gt;This article is the first detailed empirical description and analysis of a large-scale temporary healthcare service operated by the primary care divisio","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9936844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modelling lifecycles of inter-organizational collaborations in healthcare: a systematic review and best-fit framework synthesis.","authors":"Justin Avery Aunger,&nbsp;Ross Millar,&nbsp;Joanne Greenhalgh","doi":"10.1108/JHOM-01-2022-0025","DOIUrl":"https://doi.org/10.1108/JHOM-01-2022-0025","url":null,"abstract":"<p><strong>Purpose: </strong>Inter-organisational collaboration (IOC) across healthcare settings has been put forward as a solution to mounting financial and sustainability challenges. Whilst ingredients for successful IOC have been explored, there remains limited understanding of the development of IOCs over time.</p><p><strong>Design/methodology/approach: </strong>The authors systematically reviewed the literature to identify models applied to IOCs in healthcare across databases such as Healthcare Management Information Consortium (HMIC) and MEDLINE, identifying 2,763 titles and abstracts with 26 final papers included. The authors then used a \"best fit\" framework synthesis methodology to synthesise fourteen models of IOC in healthcare and the wider public sector to formulate an applied composite model describing the process through which collaborations change over time. This synthesis comprised extracting stages and behaviours from included models, selecting an <i>a priori</i> framework upon which to code these stages and behaviours and then re-coding them to construct a new composite model.</p><p><strong>Findings: </strong>Existing models often did not consider that organisations may undergo many IOCs in the organisations' lifetime nor included \"contemplation\" stages or those analogous to \"dissolution\", which might negatively impact papers using such models. The formulated' composite model utilises a life-cycle design comprising five non-linear phases, namely Contemplating, Connecting, Planning, Implementation and Maintenance or Dissolution and incorporates dynamic elements from Complex Adaptive Systems thinking to reflect the dynamic nature of collaborations.</p><p><strong>Originality/value: </strong>This is the first purpose-built model of the lifecycles of IOCs in healthcare. The model is intended to inform implementers, evaluators and researchers of IOCs alike.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9928279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural intelligence and proactive service performance: mediating and moderating role of leader's collaborative nature, cultural training and emotional labor.","authors":"Aisha Saif Al Shaer,&nbsp;Fauzia Jabeen,&nbsp;Saju Jose,&nbsp;Sherine Farouk","doi":"10.1108/JHOM-04-2022-0103","DOIUrl":"https://doi.org/10.1108/JHOM-04-2022-0103","url":null,"abstract":"<p><strong>Purpose: </strong>Drawing on cultural intelligence and social exchange theories, this study examines cultural intelligence and its effects on proactive service performance and the mediating role of leader's collaborative nature and the moderating role of cultural training and emotional labor, particularly deep acting and surface acting, in the relationship between cultural intelligence and proactive service performance.</p><p><strong>Design/methodology/approach: </strong>The study sample comprised 510 healthcare practitioners. Structural equation modeling was used to examine the hypotheses.</p><p><strong>Findings: </strong>The results show that cultural intelligence positively influences proactive service performance. Additionally, leadership's collaborative nature influences proactive service performance. The moderating effect of cultural training and deep acting positively influences the relationship between cultural intelligence and proactive service performance. In contrast, surface acting reveals a reverse effect, thus exhibiting a positive effect on this relationship.</p><p><strong>Research limitations/implications: </strong>These findings suggest that public healthcare organizations should pay more attention in improving deep acting, cultural training and leadership's collaborative nature for optimal service performance.</p><p><strong>Originality/value: </strong>The novelty of this study lies in its presentation of an integrated framework based on cultural intelligence and social exchange theories that can solve the contemporary challenges facing healthcare firms operating in emerging markets in integrating cultural intelligence and service performance.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9446515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring perceived barriers for advancement to leadership positions in healthcare: a thematic synthesis of women's experiences.","authors":"Alexandra Claire Haines,&nbsp;Eamonn McKeown","doi":"10.1108/JHOM-02-2022-0053","DOIUrl":"https://doi.org/10.1108/JHOM-02-2022-0053","url":null,"abstract":"<p><strong>Purpose: </strong>This paper aims to explore the voices of women describing the perceived barriers for advancing to leadership positions in healthcare.</p><p><strong>Design/methodology/approach: </strong>A systematic search was conducted through Elton B Stephans Company (EBSCO) host research platform using the databases Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Medical Literature Analysis and Retrieval System Online (MEDLINE) Complete and American Psychological Association (APA) PsycInfo. Nine papers were selected for this review. Thomas and Harden's (2008) method of thematic synthesis was used drawing from eight qualitative papers and one mixed methods paper describing women's lived experiences in, or advancing to, leadership positions in the healthcare sector. Analysis was conducted using three steps of thematic synthesis: the inductive coding of the text, the development of descriptive themes and the generation of analytical themes.</p><p><strong>Findings: </strong>Through the method of thematic synthesis, six descriptive themes (barriers) emerged: internalised feelings, work-life balance, lack of support, stereotypes, discriminatory behaviours and organisational culture. From these, three analytical themes were identified: personal, interpersonal and organisational.</p><p><strong>Research limitations/implications: </strong>This review looked at nine papers and documented women's voices. However, the women were in disparate geographical areas across the world and did not consider the specific cultural context in which the women were located. The healthcare sector is very large, and therefore, whilst there are shared commonalities, the disparateness could be a limitation.</p><p><strong>Practical implications: </strong>Barriers were categorised as either structural barriers or attitudinal barriers to determine the policy and practice.</p><p><strong>Originality/value: </strong>This research is crucial to better understanding what remedies need to be implemented to address gender disparity in the sector.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9176307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research engagement and research capacity building: a priority for healthcare organisations in the UK.","authors":"Stephen Peckham,&nbsp;Wenjing Zhang,&nbsp;Tamsyn Eida,&nbsp;Ferhana Hashem,&nbsp;Sally Kendall","doi":"10.1108/JHOM-12-2021-0436","DOIUrl":"https://doi.org/10.1108/JHOM-12-2021-0436","url":null,"abstract":"<p><strong>Purpose: </strong>To research involvement of healthcare staff in the UK and identify practical organisational and policy solutions to improve and boost capacity of the existing workforce to conduct research.</p><p><strong>Design/methodology/approach: </strong>A mixed-method study presenting three work packages here: secondary analysis of levels of staff research activity, funding, academic outputs and workforce among healthcare organisations in the United Kingdom; 39 Research and Development lead and funder interviews; an online survey of 11 healthcare organisations across the UK, with 1,016 responses from healthcare staff included for analysis; and 51 interviews of healthcare staff in different roles from six UK healthcare organisations.</p><p><strong>Findings: </strong>Interest in research involvement is strong and widespread but hampered by a lack of systematic organisational support despite national policies and strategies to increase staff engagement in research. While useful, these external strategies have limited universal success due to lack of organisational support. Healthcare organisations should embed research within organisational and human resources policies and increase the visibility of research through strategic organisational goals and governance processes. A systems-based approach is needed.</p><p><strong>Research limitations/implications: </strong>The research gathered data from a limited number of NHS trusts but these were purposively sampled to provide a range of different acute/community health service organisations in different areas. But data was therefore more detailed and nuanced due to a more in-depth approach.</p><p><strong>Practical implications: </strong>The findings are relevant for developing policies and practice within healthcare organisations to support research engagement. The findings also set out key policy and strategic recommendations that will support greater research engagement.</p><p><strong>Social implications: </strong>Increased research activity and engagement in healthcare providers improves healthcare outcomes for patients.</p><p><strong>Originality/value: </strong>This is a large scale (UK-wide) study involving a broad range of healthcare staff, with good engagement of nurses, midwives and Allied Healthcare Professionals who have not been previously achieved. This allowed valuable analysis of under-researched groups and comparisons by professional groups. The findings highlight the need for tailored action to embed research reporting, skills, professional development and infrastructure into organisational policies, strategies and systems, along with broader system-wide development.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9176289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organisational drivers of performance in mental health providers.","authors":"Russell Mannion,&nbsp;Frederick Hassan Konteh,&nbsp;Rowena Jacobs","doi":"10.1108/JHOM-01-2022-0017","DOIUrl":"https://doi.org/10.1108/JHOM-01-2022-0017","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare and contrast the core organisational processes across high and low performing mental health providers in the English National Health Service (NHS).</p><p><strong>Design/methodology/approach: </strong>A multiple case study qualitative design incorporating a full sample of low and high performing mental health providers.</p><p><strong>Findings: </strong>This study suggests that the organisational approaches used to govern and manage mental health providers are associated with their performance, and the study's findings give clues as to what areas might need attention. They include, but are not limited to: developing appropriate governance frameworks and organisational cultures, ensuring that staff across the organisation feel \"psychologically safe\" and able to speak up when they see things that are going wrong; a focus on enhancing quality of services rather than prioritising cost-reduction; investing in new technology and digital applications; and nurturing positive inter-organisational relationships across the local health economy.</p><p><strong>Originality/value: </strong>Highlights considerable divergence in organisation and management practices that are associated with the performance of mental health trusts in the English NHS.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10430795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10008089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The physician CEO advantage and hospital performance during the COVID-19 pandemic: capacity utilization and patient satisfaction.","authors":"Alan Belasen,&nbsp;Ariel Belasen,&nbsp;Zhilan Feng","doi":"10.1108/JHOM-04-2022-0126","DOIUrl":"https://doi.org/10.1108/JHOM-04-2022-0126","url":null,"abstract":"<p><strong>Purpose: </strong>Prior studies have shown that physician-led hospitals have several advantages over non-physician-led hospitals. This study seeks to test whether these advantages also extend to periods of extreme disruptions such as the COVID-19 pandemic, which affect bed availability and hospital utilization.</p><p><strong>Design/methodology/approach: </strong>The authors utilize a bounded Tobit estimation to identify differences in patient satisfaction rates and in-hospital utilization rates of top-rated hospitals in the United States.</p><p><strong>Findings: </strong>Among top-rated US hospitals, those that are physician-led achieve higher patient satisfaction ratings and are more likely to have higher utilization rates.</p><p><strong>Research limitations/implications: </strong>While the COVID-19 pandemic generated greater demand for inpatient beds, physician-led hospitals improved their hospitals' capacity utilization as compared with those led by non-physician leaders. A longitudinal study to show the change over the years and whether physician Chief Executive Officers (CEOs) are more likely to improve their hospitals' ratings than non-physician CEOs is highly recommended.</p><p><strong>Practical implications: </strong>Recruiting and retaining physicians to lead hospitals, especially during disruptions, improve hospital's operating efficiency and enhance patient satisfaction.</p><p><strong>Originality/value: </strong>The paper reviews prior research on physician leadership and adds further insights into the crisis leadership literature. The authors provide evidence based on quantitative data analysis that during the COVID-19 pandemic, physician-led top-rated US hospitals experienced an improvement in operating efficiency.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10820284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prosocial voice in the hierarchy of healthcare professionals: the role of emotions after harmful patient safety incidents.","authors":"John G Richmond,&nbsp;Nicola Burgess","doi":"10.1108/JHOM-01-2022-0027","DOIUrl":"https://doi.org/10.1108/JHOM-01-2022-0027","url":null,"abstract":"<p><strong>Purpose: </strong>Supporting and nurturing effective communication between healthcare professionals is vital to protect patients from harm. However, not all forms of employee voice are effective. Fear can lead to defensive voice, while the role of other emotions to drive voice behaviour is less well understood. This paper aims to understand what role the broader range of emotions, including compassion and shame, experienced by healthcare professionals following patient safety incidents (PSI) play in the subsequent enactment of prosocial voice, a positive and other-oriented form of communication.</p><p><strong>Design/methodology/approach: </strong>This study is based on data from a single English NHS hospital: interviews with healthcare professionals involved in PSIs (<i>N</i> = 40), observations at quality and risk committees and meetings (<i>N</i> = 26 h) and review of investigative documents (<i>N</i> = 33). Three recent PSIs were selected for cross-case analysis based upon organisational theory related to professional hierarchy, employee voice and literature on emotions.</p><p><strong>Findings: </strong>Among three cases, the authors found variance in context, emotional experience and voice behaviour. Where professionals feared blame and repercussion, voice was defensive. Meanwhile where they experienced shame and compassion, prosocial voice was enacted to protect patients.</p><p><strong>Practical implications: </strong>Healthcare organisations seeking to foster prosocial voice should: (1) be more considerate of professionals' emotional experiences post-PSI and ensure adequate support for recovery (2) establish norms for professionals to share their struggles with others (3) reward professionals who demonstrate caring behaviour (4) buffer professionals from workplace pressures.</p><p><strong>Originality/value: </strong>The authors' study highlights how emotional experiences, such as shame and compassion, can mediate blame and defensiveness and lead to the enactment of prosocial voice in the professional hierarchy.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10817821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}