Improving health care quality: The implementation of whistleblowing

Purpose In line with the current literature, the purpose of this paper is to contribute to a better understanding of whistleblowing procedures and their influence on overall organizational quality. To this end, institutional, organizational, and cultural barriers to whistleblowing implementation have been investigated. Design/methodology/approach A qualitative analysis based on three explorative case studies investigates and compares different whistleblowing practices implemented in health care organizations, operating within the Italian National Health Service (INHS). Findings INHS organizations have implemented whistleblowing procedures in different ways, despite the fact that the procedures are laid down by law. These differences are mainly due to cultural, administrative, organizational, and process barriers, which have a deep impact on whistleblowing integration in managerial practices and their influence on the overall quality of health processes and services. Research limitations/implications This research paper was limited by the analysis of three Italian public health care organizations, which did not allow the generalizability of findings. Therefore, the study offers interesting insights on the way effective whistleblowing systems should be implemented in order to support managers to improve organization’s management and service quality. Originality/value The paper represents one of the first attempts to structurally analyze the practice of whistleblowing in an Italian healthcare system. Therefore the study has mainly focussed not only on the analysis of whistleblowing practices, but also on their impacts on the improvement of organisational processes’ quality and, subsequently, on social well-being.