Purpose

The importance of employee voice in Resilient Healthcare (RHC) systems is not well understood and is largely underrepresented in literature. However, it is believed that stronger acknowledgement of employee voice in healthcare settings can drastically improve RHC systems. As a result, this review aims to strengthen RHC implementations by analysing where and how the employee voice should be considered.

Design/methodology/approach  

The study follows a qualitative evidence synthesis approach, in which the analysis is performed thematically. This research firstly analyses literature to identify the critical points where Resilience Engineering requires the input of employee voice to establish a truly resilient system. Secondly, it analyses literature on employee voice in healthcare to identify challenges that pose a risk to the successful implementation of RHC. The originality of this review lies in its focus on the overlap between the role of the employee voice, and specifically the critical voice, in the establishment of RHC systems.

Findings

Four RHC process steps were identified that depend on, or could benefit from, the employee voice:  the identification of critical system parameters, the critiquing of such parameters, the monitoring of the parameters, and adapting the system or addressing identified gaps. Four healthcare issues are highlighted to pose a risk to the employee voice contribution: the disregarding / discrediting of the critical employee voice, the mutual distrust between doctors and nurses, time pressure and the fear of reporting issues where there is the perception of a punitive organisation culture. A matrix summarises the intersection of these findings.