Abstract

Institutional culture barriers to staff reporting safety concerns are strong. Method: A qualitative analysis of people who went outside their organisations to effect change was conducted. The theoretical perspective of moral development is used to understand why they did this, risking professional and organisational exclusion. The concept of moral development has interdisciplinary roots in the social sciences but has rarely been applied as a theoretical approach to the study of organisations. Outcomes: The organisational responses to whistleblowing may be analysed using the moral development continuum. Conclusion: Understanding that there may be a moral development continuum for organisations is a new concept for health services but one which may prove to be a useful approach to improving safety.