Is it risking reputational damage or reputational enhancement to investigate concerns properly?

Reports of failings in healthcare are often accompanied by findings that organisations have been slow to investigate due to prioritising their reputation over meeting the concerns of staff, and wider society BBC, 2022. There is little research on what makes or breaks the reputation of a healthcare organisation. However, the UK Ombudsman in 2024 raised concerns about the extent to which hospitals are covering up evidence of poor care. When it comes to whistleblowing, there is the seeming paradox of being told it is a professional duty to raise concerns and then hearing or reading of staff being victimised or losing their employment for doing so BBC, 2023.

There is evidence reputation is associated with better clinical care Hibbard, 1997. Hospital reputation may act as a shield against litigation and may also help attract and retain talented staff. Healthcare reputation includes domains such as:

• Quality of service
• Confidence
• Ethical conduct
• Management and leadership
• Social responsibility
• Biomedical innovation and research

When a healthcare organisation has a higher reputation, patients and relatives believe it also offers a safer clinical environment. Improving reputation can mitigate the effect of adverse events on the perception of patients. A study in Spain found:

• Confidence in the competence of professionals
• Belief that the treatments applied at the hospital lead to the desired results
• The hospital’s good reputation

were all directly associated with a perception the hospital is a safe clinical environment and the relatives thought few clinical errors were committed.

Reflection

• Clinical performance is associated with staff wellbeing
• A culture of incivility and rudeness damages cognitive function and clinical reasoning by frontline healthcare staff
• When staff raise concerns about culture and patient safety and bring these to senior leaders, would it not enhance the reputation of an organisation to be seen to take these concerns seriously and investigate them properly?
• What would be the impact on staff confidence, wellbeing and retention of doing so?
• Would there be any benefit to anyone in organisations not doing this?

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