Investigating Physicians’ Views on Soft Signals in the Context of Their Peers’ Performance

By 3 november 2018 april 18th, 2019 Teameffectiviteit

BACKGROUND

Physicians are responsible for delivering high quality of care. In cases of underperformance, hindsight knowledge indicates forewarning being potentially available in terms of concerns, signs, or signals. It is not known how the physicians involved perceive such signals.

PURPOSE

To openly explore how physicians perceive soft signals and react on them.

METHODS

In-depth interviews with 12 hospital-based physicians from various specialties and institutions following the interpretative phenomenological analysis approach.

RESULTS

Physicians perceive soft signals as an observable deviation from a colleague’s normal behavior, appearance, or communication. Once observed, they evaluate the signal by reflecting on it personally and/or by consulting others, resulting in either an active (i.e., speaking up) or passive (i.e., avoidance) reaction. Observer sensitivity, closeness to the peer, and cohesion of the physician group influence this observation-evaluation-reaction process.

CONCLUSIONS AND IMPLICATIONS

Physicians perceive soft signals as indicators of well-being and collegiality, not as concerns about performance or patient safety. They feel it is their responsibility to be sensitive to and deal with expressed signals. Creating a psychological safe culture could foster such an environment. Because a threat to physicians’ well-being may indirectly affect their professional performance, soft signals require serious follow-up.

Author

Myra van den Goor, Partner Q3

Full text

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