Filling Voice Promotion Gaps in Healthcare through a Comparative Analysis of Error Reporting and Learning Systems and Open Communication and Disclosure Policies in the United States and Germany

Am J Law Med. 2018 Nov;44(4):579-605. doi: 10.1177/0098858818821137.


Voice in healthcare is crucial because of its ability to improve organizational performance and prevent medical errors. This paper contends that a comparative analysis of voice promotion in the American and German healthcare industries can strengthen a culture of safety in both countries. It provides a brief introduction to the concept of voice in healthcare, including its impact on safety culture, barriers to voice, and the dual influences of confidentiality and transparency on voice promotion policies. It then examines the theoretical basis, practical workings, and legal aspects of voluntary error reporting and error disclosure as avenues for exercising voice in the U.S. and Germany. Finally, it identifies transferable practices that can remedy shortcomings in each country's voice promotion policy.

Publication types

  • Comparative Study

MeSH terms

  • Communication
  • Disclosure / ethics*
  • Efficiency, Organizational / legislation & jurisprudence*
  • Germany
  • Government Regulation
  • Humans
  • Medical Errors / ethics*
  • Medical Errors / legislation & jurisprudence*
  • National Health Programs / legislation & jurisprudence
  • Quality Assurance, Health Care / legislation & jurisprudence
  • Risk Management
  • Safety Management / ethics
  • Safety Management / legislation & jurisprudence*
  • United States