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This comment argues that instead of worrying about the pros and cons of whistleblowing one should focus on the more general problem of the failure of upward communication around safety and quality problems and consider what leaders and managers must do to stimulate subordinates to communicate and reward such communication. The article analyzes why safety failures occur and introduces the concept of practical drift and adaptive moves as necessary for systemic safety to be understood and better handled. It emphasizes the key role of senior leadership in creating a climate in which critical upward communication will become more likely.

international journal of health policy and management

Whistle Blowing: A Message to Leaders and Managers Comment on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organizations"