Errors are a recurring fact of organizational life and can potentially yield either adverse or positive consequences. Organizational researchers and practitioners alike have become increasingly interested in understanding the causes of errors and the coping strategies that foster organizational success. Although we have learned much about errors in specific research areas across specific organizational contexts, we know little about how multifaceted forces in organizations, especially when they contradict each other, might affect the pathways of errors in organizations. This review strives to integrate the literature on errors, not only by summarizing conceptual foundations and empirical findings, but also by discussing discrepancies, inconsistencies, and opportunities for research synthesis via level of analysis, temporal dynamism, and priority lenses. At the core of this integrative review is a call for future research to explain how to reduce the underlying causes and negative consequences of errors while promoting positive outcomes and learning benefits in organizations. We close this review by offering suggestions that help develop an integrative, rather than isolated, investigation of errors in organizations.

Background: Prior research has found that adverse events have significant negative consequences for the patients (first victim) and caregivers (second victim) involved such as burnout. However, research has yet to examine the consequences of adverse events on members of caregiving units. We also lack research on the effects of the personal and job resources that shape the context of how adverse events are experienced. Objectives: We test the relationship between job demands (the number of adverse events on a hospital nursing unit) and nurses’ experience of burnout. We further explore the ways in which personal (workgroup identification) and job (safety climate) resources amplify or dampen this relationship. Specifically, we examine whether, and the conditions under which, adverse events affect nurse burnout. Research Design: Cross-sectional analyses of survey data on nurse burnout linked to hospital incident reporting system data on adverse event rates for the year before survey administration and survey data on workgroup identification and safety climate. Subjects: Six hundred three registered nurses from 30 nursing units in a large, urban hospital in the Midwest completed questionnaires. Results: Multilevel regression analysis indicated that adverse events were positively associated with nurse burnout. The effects of adverse events on nurse burnout were amplified when nurses exhibited high levels of workgroup identification and attenuated when safety climate perceptions were higher. Conclusions: Adverse events have broader negative consequences than previously thought, widely affecting nurse burnout on caregiving units, especially when nurses strongly identify with their workgroup. These effects are mitigated when leaders cultivate safety climate.

More is known about the structural features of health system integration than the social features—elements of normative integration (alignment of norms) and interpersonal integration (collaboration among professionals and with patients). We surveyed practice managers and 1,360 staff and physicians at 59 practice sites within 17 health systems (828 responses; 61%). Building on prior theory, we developed and established the psychometric properties of survey measures describing normative and interpersonal integration. Normative and interpersonal integration were both consistently related to better provider experience, perceived care quality, and clinical integration (e.g., a 1-point increase in a practice’s normative integration was associated with 0.53-point higher job satisfaction and 0.77-point higher perceived care quality in the practice, measured on 1 to 5 scales, p < .01). Variation in social features of integration may help explain why some health systems better integrate care, pointing to normative and interpersonal integration as potential resources for improvement.

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