Openness in healthcare leadership

Openness is increasingly recognised as crucial to organisations’ ability to learn and improve their systems and processes, and to healthcare organisations’ ability to provide safe, high-quality services to patients. The role of healthcare leaders in making their organisations more open, however, has not been a central focus of the literature. In this chapter, we describe the claimed benefits of openness in healthcare organisations, and the problems that its absence can cause. We discuss some of the challenges that leaders face in promoting openness, particularly given the characteristics of healthcare, such as dynamics between occupational groups, the existence of ‘blame cultures’, and the uncertain nature of some healthcare practice which can make identifying and voicing concerns difficult. We offer a critical overview of some of the interventions available to foster openness, before distilling some general messages for how leaders might approach the challenge of encouraging openness among colleagues, within teams, and across organisations.