How difficulties in upward voice lead to lateral voice: a case study of a Chinese hospital

Purpose The aim of this study is to explore and unpack the notion of lateral voice within the context of a Chinese hospital. Design/methodology/approach A qualitative design was used, involving interviews of 24 medical personnel from a public hospital in mainland China. This included two focus groups (eight participants each) of physicians and nurses, and eight individual interviews with managers, including a chief nurse and directors of the medical centre. Findings The findings reveal that in top-down contexts with a respect for hierarchy, direct and vertical voice is discouraged but lateral voice fills this gap and can lead in some circumstances to a pathway to collective vertical voice. Interestingly, the study finds that fear of damaging relationships with peers may also discourage lateral voice in some cases, leading to silence altogether. Contradictory lateral voice outcomes arising from employees working within this context are discussed. Originality/value The study makes an original contribution to voice literature through exploring an understudied voice target, that is, voicing to peers. In doing so, the study demonstrates the importance of lateral voice as an important component of voice behaviour.