Factors that prevent physicians reporting adverse events

Moumtzoglou, Anastasius

doi:10.1108/09526861011010677

Cited by 15 publications

(26 citation statements)

References 12 publications

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“…Underreporting of incidents has been well documented in medicine and is an ongoing issue in MRS as well . The various reporting requirements of the state jurisdictions within Australia also contribute to the underreporting of adverse events .…”

Section: Discussionmentioning

confidence: 99%

“…James Reason, the esteemed author in the field of human error, argues that for error reporting to make a meaningful contribution to safety the culture of blame and culpability must be replaced with a reporting culture . The fear of blame and reprisals when reporting adverse events is well documented in medicine and may be a reason for underreporting in MRS. This is an area for possible further research.…”

Section: Discussionmentioning

confidence: 99%

“…13 Despite errors associated with patient identification being difficult to eliminate, a system of patient and procedure matching like the one proposed by Danaher et al 14 demonstrated significant improvements can be achieved. Underreporting of incidents has been well documented in medicine [15][16][17] and is an ongoing issue in MRS as well. 14,[18][19][20] The various reporting requirements of the state jurisdictions within Australia also contribute to the underreporting of adverse events.…”

Section: Unlicensed Use Of Radiation Apparatusmentioning

confidence: 99%

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Recommendations for radiographers and radiation therapists drawn from an analysis of errors on Australian Radiation Incident Registers

Denham

Page

2017

J Med Radiat Sci

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IntroductionThe Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) collect reported incidents for inclusion in the Australian Radiation Incident Register (ARIR), a database of radiation incident reports that occur within Australia. While the information on previous radiation incidents is available, there is little information on the lessons that can be learned from those past incidents to help prevent the same errors reoccurring. The aims of the study were to investigate what radiation incident registers are publicly available in Australia and to utilise the information contained within the ARIR and any other state or territory radiation protection authority registers to make recommendations for radiographers and radiation therapists to prevent future adverse events.MethodsA search was conducted to locate what radiation incident registers within Australia were available to the public. All adverse events from 2003 to 2014 were compiled into a spreadsheet for analysis. An error‐type classification taxonomy was used to classify the adverse events. Conclusions were drawn from the determined causes to make recommendations to change work practices in an attempt to prevent similar adverse events reoccurring.ResultsIncident registers were located from New South Wales, South Australia, Tasmania, Victoria and Western Australia. Radiography represented 76% (243) of the adverse events. A vast majority of the incidents were a failure to comply with time‐out protocols (77%, 248).ConclusionThere are several radiation adverse event registers publicly available to utilise in Australia. All departments need to adopt and strictly adhere to time‐out protocols. This in conjunction with the other recommendations in this article has the potential to dramatically reduce radiation adverse events.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Unlicensed Use Of Radiation Apparatusmentioning

confidence: 99%

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Recommendations for radiographers and radiation therapists drawn from an analysis of errors on Australian Radiation Incident Registers

Denham

Page

2017

J Med Radiat Sci

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“…However, health care organizations often do not learn from failures, and this failure to learn is, at least in part, due to underreporting of errors and near misses by the frontline clinicians [ 6 ]. A number of factors have been identified that explain the low rates of error reporting including the belief that error reporting will not lead to safety improvements [ 7 , 8 ], confidentiality and legal concerns [ 9 ], a punitive work environment [ 10 ], traditions of professional autonomy [ 6 ], perfectionism [ 7 , 11 ], power hierarchies within and between professional groups [ 10 , 12 , 13 ], and poorly designed reporting systems [ 8 , 14 ]. While it is important for health care organizations to take steps to increase the rates of error reporting, they must not lose sight of the fact that error reporting by itself can be counterproductive if it does not lead to error analysis and system improvements [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding nurses’ and physicians’ fear of repercussions for reporting errors: clinician characteristics, organization demographics, or leadership factors?

Castel

Ginsburg

Zaheer

et al. 2015

BMC Health Serv Res

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BackgroundIdentifying and understanding factors influencing fear of repercussions for reporting and discussing medical errors in nurses and physicians remains an important area of inquiry. Work is needed to disentangle the role of clinician characteristics from those of the organization-level and unit-level safety environments in which these clinicians work and learn, as well as probing the differing reporting behaviours of nurses and physicians. This study examines the influence of clinician demographics (age, gender, and tenure), organization demographics (teaching status, location of care, and province) and leadership factors (organization and unit leadership support for safety) on fear of repercussions, and does so for nurses and physicians separately.MethodsA cross-sectional analysis of 2319 nurse and 386 physician responders from three Canadian provinces to the Modified Stanford patient safety climate survey (MSI-06). Data were analyzed using exploratory factor analysis, multiple linear regression, and hierarchical linear regression.ResultsAge, gender, tenure, teaching status, and province were not significantly associated with fear of repercussions for nurses or physicians. Mental health nurses had poorer fear responses than their peers outside of these areas, as did community physicians. Strong organization and unit leadership support for safety explained the most variance in fear for both nurses and physicians.ConclusionsThe absence of associations between several plausible factors including age, tenure and teaching status suggests that fear is a complex construct requiring more study. Substantially differing fear responses across locations of care indicate areas where interventions may be needed. In addition, since factors affecting fear of repercussions appear to be different for nurses and physicians, tailoring patient safety initiatives to each group may, in some instances, be fruitful. Although further investigation is needed to examine these and other factors in detail, supportive safety leadership appears to be central to reducing fear of reporting errors for both nurses and physicians.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0987-9) contains supplementary material, which is available to authorized users.

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“…In order to overcome these organisational, situational and individual obstacles of voice, increasing efforts are undertaken to better understand and develop strategies against them (Gallagher et al, 2006; Moumtzoglou, 2010; Rosen et al, 2005). For instance, employer-sponsored voice practices (ESVPs) – such as critical incidence reporting systems (CIRSs) – have been adopted from other high-risk professions.…”

Section: Introductionmentioning

confidence: 99%

Disclosure of adverse outcomes in medicine: A questionnaire study on voice intention and behaviour of physicians in Germany, Japan and the USA

Loewenbrück

Wach

Müller

et al. 2016

German Journal of Human Resource Management: Zeitschrift für Pe

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Factors that prevent physicians reporting adverse events

Abstract: The study provides an understanding why physicians fail to report adverse events so that systems can be introduced and cultures developed, which make this easier.

Cited by 15 publications

References 12 publications

Recommendations for radiographers and radiation therapists drawn from an analysis of errors on Australian Radiation Incident Registers

Recommendations for radiographers and radiation therapists drawn from an analysis of errors on Australian Radiation Incident Registers

Understanding nurses’ and physicians’ fear of repercussions for reporting errors: clinician characteristics, organization demographics, or leadership factors?

Disclosure of adverse outcomes in medicine: A questionnaire study on voice intention and behaviour of physicians in Germany, Japan and the USA

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