Disclosing and reporting medical errors

Abstract

Willingness to disclose or report errors varied widely between hospitals. Thus, heads of department and hospital chiefs need to be aware of the importance of local culture when it comes to error communication. Error disclosure training and improving feedback on how error reports are being used to improve patient safety may also be important steps in increasing anaesthesiologists' communication of errors.

Prevalence of non-reporting of hospital medical errors in the Islamic Republic of Iran

“…A survey among nurses from hospitals affiliated with Tehran and Shiraz Universities of Medical Sciences listed fear of legal action, job threats and a negative culture of blame were reported as major impediments (28). Other studies, including one from the Netherlands, indicated that fear of legal complaints was not a significant concern for internists and residents reporting medical errors (8,28).…”

“…The World Health Organization published an instructional guideline for medical students in 2009 which included 11 topics on patient safety (31). Multiple studies indicate that most medical students receive little information about medical errors or reporting techniques (31,32), and staff physicians and nurses also do not receive adequate information (8). Throckmorton et al showed nurses could not identify errors in 40% of cases (33), although no practical scenario was provided for the accurate assessment of medical error recognition and understanding in this study, and there was evidence that 73.5% of nurses and almost half of physicians and medical students had an inadequate background on the topic.…”

“…Efficiency, security of care, caregiver reactivity and patient contentment are safety parameters that are at the core of healthcare quality (3). The most crucial factor, however, is a comprehensive understanding of medical errors (8). Gathering meticulous evidence via transparent incident reporting, free sharing of data and the creation of a culture of learning from our mistakes are indispensable in the development of medical error reduction plans and improving patient safety (2,5,9).…”

“…Understanding the multiple factors that influence reporting errors among healthcare workers is crucial to supplying missing elements of an effective communication programme. Such barriers can damage the transparency of a safety climate and a culture of learning from errors (8,13,14).…”

“…On the institutional level, the safety climate often determines frontline provider attitudes (13). Loss of malpractice insurance coverage, fear of punitive actions, time constraints, poorly designed reporting systems, negative feedback, lack of confidentiality and a power hierarchy within professional groups are factors that negatively affect error reporting (2,8,13,14). Other factors can be even more specific, such as fear of disciplinary action and threats to positive evaluations and promotion, especially among nurses (2,13,15).…”