ABSTRACT
This chapter reports a study that explored the speak-up culture in an intensive care unit (ICU) at one Hong Kong hospital. Doctors and nurses reported their perceptions of communication openness during intra- and interdisciplinary communication. A cross-sectional survey of the ICU nurses and doctors was conducted using an established measure of ICU teamwork. The survey was adapted, validated, and reviewed by a panel of ICU medical and nursing experts. Eighty staff working in an ICU completed the survey about their perceptions of speak-up and self-reported ability of communication openness. Based on their survey responses, ten of the respondents with high communication openness were selected to participate in an audio-recorded observation of their handover practices. This was followed by semi-structured interviews to elicit their views on factors that affect speak-up culture in the ICU, at what critical moments they speak up, and their motivations for desirable speak-up practices.
