Employee voice in healthcare: a systematic review

Purpose: We aim to advance our understanding by examining voices related to employees' own interests and associated outcomes for employees and healthcare organizations. Patient safety reviews do not explore contextual factors such as organizational or professional cultures and regulatory environments in depth, and arguments for overcoming barriers to voice in health are underdeveloped. The research has largely developed in separate literature (various subdisciplines of management and the health field), and we outline the divergent emphases and opportunities for integration with the aim of investigating all relevant contextual factors and providing guidance on best practice informed by multiple disciplines.

Design/methodology/approach: A systematic approach was taken to gathering and reviewing articles, and coding and reporting are in line with the most recent Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (Rethlefsen et al., 2021).

Findings: We identified a range of facilitators, barriers and outcomes of employee interest voice at different levels (organizational, leadership, team or individual) in a healthcare context. We identify various theoretical, methodological and knowledge gaps, and we suggest several ways in which these can be addressed in future research efforts.

Practical implications: We make multiple contributions to both theory and practice, including highlighting the importance and implications of integrating disciplinary approaches, broadening context, improving research design and exploring under-researched samples and topics. This information is essential in providing a more comprehensive model of healthcare voice and to shifting management focus to include all forms of employee voice in healthcare for the benefit of staff and patients.

Originality/value: We make multiple contributions to both theory and practice including highlighting the importance of integrating disciplinary approaches, broadening context to include employee interest issues, improving research design and exploring under-researched samples and topics. This information is essential in providing a more comprehensive model of health care voice and to shifting management focus to take a more inclusive view of employee voice in healthcare for the benefit of staff as well as patients.