3 Communicating and Escalating Concerns

Communicate concerns clearly

Raise a concern promptly, calmly, and specifically. Describe what you observed, when and where it happened, who or what may be affected, and what action is needed. Distinguish direct observations from assumptions, and avoid blame or speculation.

For a complex or urgent issue, use SBAR to make the message clear:

• Situation: What is happening now?

• Background: What relevant context is needed?

• Assessment: What is the concern or possible risk?

• Recommendation: What action or response are you requesting?

For example, report that a press guard is loose, where and when you noticed it, that the machine is still in use, and that someone could be injured; request that its use stop and that it be inspected. Clear, timely reporting helps responsible staff respond to hazards and near misses.

If a safety concern is not acknowledged, state it again directly. In team settings, TeamSTEPPS guidance recommends voicing a safety concern at least twice. If it remains unresolved, take stronger action by contacting a supervisor or using the chain of command.

Choose a reporting channel

Use the organization’s established reporting procedure and select a channel suited to the urgency and nature of the concern.

• Immediate danger or emergency: Follow the emergency action plan, alert the designated responder or supervisor, and contact emergency services when appropriate. Do not rely on a routine form or email to report an emergency.

• Urgent operational or safety concern: Tell the responsible supervisor or team lead directly through an approved urgent channel, then confirm the message was received.

• Non-urgent issue, near miss, or improvement idea: Use the designated reporting system, meeting, or written process, providing enough detail for follow-up. Organizations should have a process for receiving concerns and responding to them.

• Concern involving your supervisor, or an unresolved concern: Follow the next level in the chain of command or use the organization’s designated safety, compliance, or confidential reporting route. Follow applicable policy and legal requirements.

Share sensitive information only through authorized channels and only with people who need it to respond.

Escalate unresolved concerns

Escalation means passing a concern to someone with the authority or expertise to address it when the initial response is missing, delayed, or inadequate. Follow local procedures, but do not let a routine chain-of-command step delay action when there is immediate danger.

When passing the concern on, give the next person the original facts, the actions already taken, the response received, and what remains unresolved. Ask who will take responsibility and when you should expect an update.

If the issue is still not addressed, continue to the next designated level or reporting route. Organizations should respond promptly to reports and communicate what action was taken when possible.

Apply the process to a safety concern

During a practice session, you notice a participant using equipment in a way that could cause injury. Clearly describe the risk and ask them to stop. If the risk continues, alert the session lead immediately. If the danger is imminent, follow the emergency procedure rather than waiting for a routine debrief. Once the immediate risk is controlled, submit the required report and notify the appropriate person if further action is needed.

Keep the response timely

Report concerns promptly and factually. Match the channel to the urgency, confirm that the message was received, and follow the established escalation route if the issue remains unresolved. In an emergency, use emergency procedures without delay.