Assessment of knowledge and attitudes towards safety events reporting among residents in a community health system

Abstract

Background: Resident physicians are known to be infrequent reporters of patient safety events (PSE). Previous studies assessing barriers to resident PSE reporting have not considered possible cultural barriers faced by international medical graduates (IMG). This study aimed to assess the knowledge and attitudes of residents regarding PSE and possible barriers contributing to poor resident reporting.Methods: A cross sectional survey of all house staff undergoing post-graduate residency training at two independent community hospital based academic medical centers was conducted through an online questionnaire. Sample case vignettes were created to assess the residents’ ability to identify safety events and classify them as near miss, adverse events or sentinel events and decide whether they were reportable.Results: The Reporting of PSE increased significantly by year of residency training (p < 0.005), with time taken to file a PSE being the strongest perceived barrier. There was no difference in PSE reporting between IMG’s and non- IMG’s. We identified major knowledge gaps with only 73.9%, 79.6% and 94.3% of respondents correctly identifying sentinel events, adverse events, and near misses, respectively. 58.1% of respondents did not think near misses were reportable.Conclusions: A lack of knowledge is the most important barrier towards PSE reporting. A different cultural background and lack of previous exposure to patient safety report by IMGs is not a significant barrier towards safety event reporting. In the short-term, it appears that focusing limited institutional resources on education rather than acculturation issues would have the greatest benefit.

The effect of patient safety culture on nurses’ near-miss reporting intention: the moderating role of perceived severity of near misses

“…Given the positive effect of patient safety culture, we, therefore, proposed that:Hypothesis One: patient safety culture relates positively to nurses’ near-miss reporting intention.Error characteristics, particularly the severity of consequences, have been reported to be a critical element affecting safety performance (Chuang et al., 2007; Homsma et al., 2009; Kodama and Kanda, 2010). A study among resident physicians showed that 58.1% of respondents were more inclined to report serious errors compared with near misses (Singal et al., 2018). Most previous studies focused on actual adverse events, making it reasonable that the greater the severity of the event, the more necessary the report.…”

Interventions to improve resident reporting of patient safety events: a quality improvement initiative

“…That study revealed that knowledge regarding what constitutes a PSE was the major barrier limiting the reporting. Similar to other studies, secondary barriers included time and complexity of the reporting process, lack of feedback, and perceived failure to resolve the issue despite reporting [6].…”

“…It included possible barriers to reporting, expressed on a Likert scale as well as three clinical vignettes designed to assess the residents' ability to identify safety events and classify them as near miss, adverse events or sentinel events and indicate whether they were reportable or not. The questions also assessed the respondent's demographic data such as gender, speciality and current level of training and medical school background [6].…”

“…Resident physicians at Rochester General Hospital (RGH), Rochester, NY, a 528-bedded urban community teaching hospital, filed only 29 PSE reports in the preceding 3 years. Similarly, resident physicians and faculty at Unity Hospital (UH), Rochester, NY, a 351-bedded suburban community teaching hospital submitted only 22 out of 2133 PSE reports filed during academic year 2016–17 [ 6 ]. This led to a resident-led quality improvement project to assess our residents’ knowledge regarding PSE and to identify the barriers contributing to low PSE reporting.…”

Trend Analysis of Patient Safety Incidents and Their Associated Factors in Korea Using National Patient Safety Report Data (2017~2019)

“…The severity of PCIs was classified as near miss, adverse, and sentinel events, based on previous studies [13,24,25]. A near miss is defined as a preventable event in which a situation that could cause injury to a patient occurs, but leads to no actual injury [26,27].…”