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Listening and Speaking Up to Improve Safety

​​Health care professionals’ skills in speaking up and listening about patient care concerns, are essential to safeguarding patient safety. Furthermore, these important communication skills help shape the organizational culture where individuals engage in discussions, pose questions, challenge the decision of an authority figure, and offer alternative ideas without the fear of repercussion. In this context, clinicians’ emotional intelligence about the factors that make speaking up and listening feel challenging or feasible is important. 

Additionally, understanding how organizational culture, such as psychological safety and power hierarchy, become a barrier to rather than facilitator of speaking up and listening. This can lead to strategizing both our verbal and emotional skills for effective speaking up and listening.

In the Institute for Healthcare Improvement (IHI) Virtual Learning Hour, Listening and Speaking Up to Improve Safety, on October 29, 2020, from 12:30 PM – 1:30 PM ET, IHI will introduce participants to emotionally intelligent verbal skills and apply them to real-life scenarios that involve speaking up and listening.


By the end of this IHI Virtual​ Learning Hour​ you’ll be able to:

  • Describe psychological safety as an essential building block of ensuring speaking up and listening skills
  • Discuss the role of "speaking up climate" within patient safety culture  
  • Explain key barriers to and facilitators of speaking up and listening when navigating power hierarchy

  • Apply speaking up and listening skills to real-life scenarios where power hierarchy is at play

This IHI Virtual Learning Hour is approved for 1 Continuing Education Credit for physicians, pharmacists,​ nursing and CPPS recertification.​​​​​


Bell 5.jpg
Sigall Bell, MD, is the Director of Patient Safety and Discovery at OpenNotes and Associate Professor of Medicine at Harvard Medical School. A recipient of a Gold professorship, Dr. Bell’s research focuses on patient engagement, patient safety, and speaking up. As part of the OpenNotes team since its inception, Dr. Bell has contributed to the growth of patient access to their visit notes online to more than 40 million patients in every US state today. Together with her colleagues, Dr. Bell has trained 1,000clinician leaders in medical error disclosure and has co-led development of a research agenda focused on preventing longterm emotional harm to patients and families. She is a health care innovator working to build safer care through health information transparency and stronger partnerships between patients and clinicians.

Kim_Sara-2.jpg Sara Kim, PhD, is the Associate Dean for Educational Quality Improvement, School of Medicine, University of Washington. As a Research Professor of Surgery, Dr. Kim received her PhD in Education in 1999 from University of Washington, Seattle, Washington. Dr. Kim is the inaugural holder of the George G. B. Bilsten Professorship in the Art of Communication with Peers and Patients. She actively leads research programs in conflict management and collaborates with a wide range of clinical, administrative and educational stakeholders across UW Medicine. Since 2014, she and her team have developed training programs and taught more than 5,000 health care professionals communication skills associated with conflict management and resolution. Dr Kim's work has been primarily supported through the Arnold P. Gold Foundation Humanism in Medicine grants and the UW Medicine Patient Safety Innovation Programs.

Eric Thomas 1.jpgEric J. Thomas, M.D., M.P.H. is a Professor of Medicine and Associate Dean for Healthcare Quality at the McGovern Medical School at the University of Texas Health Science Center at Houston. Dr Thomas also directs the UT Houston-Memorial Hermann Center for Healthcare Quality and Safety. Since 1992, Dr. Thomas has conducted research on patient safety and his work was heavily cited in the Institute of Medicine's reports To Err is Human (2000),and Improving Diagnosis in Health Care (2015). Dr. Thomas’ current research focuses on topics such as diagnostic errors, measuring safety culture, and engaging families and frontline clinicians in detecting harm and improving patient safety. In 2007 he received the John M. Eisenberg Patient Safety and Quality Award for Research from the National Quality Forum and Joint Commission.


Jessica BehrhorstJessica Behrhorst, MPH, CPPS, CPQH, CPHRM, is Senior Director, Patient Safety at IHI. Prior to joining IHI, she served as the Assistant Vice President of Quality and Patient Safety at Ochsner Health System where she oversaw various projects involving patient safety, performance improvement, regulatory readiness, ambulatory nursing, and quality outcomes. In her time there she also led the system-wide implementation of Root Cause Analysis and Action (RCA2). She has presented her work on (RCA2) and Improving the Culture of Safety at various regional and national meetings. She has also worked on research projects involving reduction in s​epsis mortality and access to health care for underserved populations. Jessica received her bachelor's degree from Tulane University and her Master of Public Health Degree from the Louisiana State University School of Public Health. She is a Certified Professional in Patient Safety (CPPS), a Certified Professional in Healthcare Quality (CPHQ) and a Certified Professional in Healthcare Risk Management (CPHRM).