2208 Title: When Case Managers Fail To Speak Up: Ethical Issues and Recommendations Date / Time: Thursday, June 10, 2010 at 04:15 PM - 05:45 PM Type: CONCURRENT Level: INTERMEDIATE Sponsor(s): HPSO Speaker(s): John Banja; Kathy D. Craig When Case Managers fail to speak up, it is often because they are unclear about their professional obligation to do so.  They fear outright retaliation, or they lack confidence that, by speaking up, it will result in a constructive organizational response. In the session, "When Case Managers Fail To Speak Up: Ethical Issues and Recommendations," Kathy Craig and Dr. John Banja discuss how such failures result in harms, or enable a dangerous or deviant system to persist. Also, the presenters describe rationalizations that Case Managers might use in their decisions to stay silent; identify root, systemic causes that thwart speaking up; and, make recommendations for cultivating constructive speaking up demeanors. Using several scenarios, Dr. Banja and Ms. Craig draw from interactive collaborations inherent in Case Management (CM) to illustrate how ethical principles emphasize patient-centered obligations and duties to perform. Examples of not speaking up are used to illustrate professional lapses and system failures that contribute to untoward results, including harm-causing errors that jeopardize patient safety and foment low morale. In addition to the fear of retribution, the presenters offer possible explanations about why CM professionals resist speaking up, such as role uncertainties and latent system, or organizational causes. They use the case scenarios to discuss timing, content, and presentations of positive speaking up. Additionally, recommendations are explored that Case Managers and the organizations that employ them can use to cultivate environments in which system-enhancing communication behaviors exist, safety-inducing action plans thrive, and operators feel safe and supported for speaking up. All these factors contribute to the ability of Case Managers, their patients and clients, and the collaborative professionals who participate in CM to experience a healthy sense of self from exercising the skills, talents, and courage to speak up constructively. Objectives: Describe how Case Managers’ failures to speak up can lead to increased risks for clients (patients), healthcare providers, and the organizations that employ case managers. Use the 3-color flag system to demonstrate analyzing poor, better, and best choices of actions to avoid or talk about how, when, and to whom to speak up. List 3 strategies Case Managers and organizations can use to encourage speaking up behaviors.