Make it easier to raise a concern

What we found in the news

The Agency for Healthcare Research and Quality's CUS communication tool (opens in a new tab), created and reviewed in May 2023, offers shared language for raising a safety concern. Its steps move from stating concern to explaining discomfort and identifying an unresolved safety issue.

One instruction is simple:

“Then, state why you are uncomfortable.”

— AHRQ, Tool: CUS, second step

CUS belongs to the TeamSTEPPS professional teamwork curriculum. We are using that guidance to think about the conditions around speaking up, rather than claiming that one phrase will solve every communication problem.

Why this matters to us

Imagine a new staff member helping someone prepare to leave a day program. In this illustrative situation, the expected transport has not arrived, but a different driver says they have come to collect the person. The staff member is unsure whether the change has been confirmed.

Their uncertainty deserves a route to an answer. Experience may help a colleague recognize the arrangement; it should not be a prerequisite for asking about it.

At genus, we want care-team communication to make useful questions easier to raise. That includes questions from people receiving care. Someone may notice that the plan being discussed does not match what they agreed to, or that a detail has been misunderstood.

Name what you have noticed

A concrete concern gives a colleague something to investigate. Explain the observation, the part that is unclear and why it matters to the next action.

In the transport example, the issue is the unconfirmed change. Staff should use the organization's collection and escalation procedures; this article is not a replacement for them.

Avoid turning uncertainty into an accusation. Equally, do not require a person to collect perfect evidence before reporting something important. They may have noticed only one piece of the situation.

A manager can help by making the route explicit during induction. Which colleague handles a routine clarification? Where does a safety concern go? What happens when the usual person is unavailable? Clinical emergencies and safeguarding concerns need their established, immediate procedures, not a queue of routine messages.

These distinctions are practical. They keep a worker from having to guess whether a note in a general channel is enough.

Make the response visible

Listening includes what happens after the concern is raised. The receiving colleague can acknowledge the question, explain who is looking into it and say what the staff member should do while the answer is being found.

Sometimes the response will be that the arrangement has already been checked. Explain how that was confirmed and where the relevant information belongs. A clear explanation gives the next person something useful to learn.

Sometimes there is still a gap. Record it accurately through the appropriate process and follow the required escalation route. A conversation that ends with everyone assuming someone else will act has not settled the question.

For the person receiving support, uncertainty may be easier to manage when someone explains what is happening in a way they can use. They should not be discussed as though they are absent while staff resolve an arrangement around them.

Practice the receiving side

Teams often rehearse how to speak up. It is also worth rehearsing how to receive a concern when the day is busy and the question challenges an earlier decision.

Use a fictional example in a staff discussion. Ask one colleague to explain an uncertainty and another to respond. Notice whether the response makes the next action clear. No one needs to perform a dramatic confrontation for this to be useful.

Managers can also ask, privately where appropriate, whether newer colleagues know what happens when their first contact cannot resolve something. That question is about the process, not a test of confidence.

Do not turn reporting volume into a simple score for staff performance. A change in reports can have several explanations and needs context.

The genus connection

Today, genus team workflows can support recording and reviewing observations within an organization's configured modules. Keeping relevant context available may help the responsible staff member understand a question.

A saved observation or sent message does not establish that someone has seen it. The organization must define its response arrangements, appropriate channels and urgent escalation procedures. No routine digital workflow should be presented as an emergency response service.

The contribution we look for is modest and useful: less searching for the context around a concern, alongside a clear human responsibility to respond.

One question to take away

If a new colleague raised an unresolved concern today, would they know who will respond and what to do next?