Missing chances to learn: a case study of barriers to near-miss reporting in a hospital

Abstract

Purpose The purpose of this paper is to identify the barriers of near miss (NM) reporting among healthcare workers in a governmental hospital in Saudi Arabia. Design/methodology/approach This is a mixed methods study, composed of a survey, followed by a set of semi-structured interviews which were conducted to get a more in depth understanding of some of the aspects covered in the questionnaire. Findings The research shows that the main barrier to reporting NMs in the hospital is a fear of professional and departmental consequences. Differences between employee groups are evident in their perceptions, special attention should be given to that when developing a programme to improve reporting. Research limitations/implications First, the sample size may not be representative of the hospital’s population, because the response rate from nurses was significantly higher than from professional groups. Second, the questionnaire only captures the perceptions of employees about these barriers and not the actual barriers. Those who did not respond to the questionnaires might hold different views to those who responded, providing bias in the results. Practical implications These findings show that a focus on NMs in particular is lacking in Saudi Arabia, despite the valuable learning opportunities they may hold. Better understanding of these factors is likely to aid hospital leaders in talking the barriers identified, so that the potential of NM reports can be maximised to improve hospital systems. Originality/value This research draws attention to the attitudes of healthcare workers to NM reporting, most previous studies were focussed on the barriers of adverse events or error reporting in general, rather than NMs.

Assessment of the organizational factors in incident management practices in healthcare: A tree augmented Naive Bayes model

“…Given their frequency and significance, increased attention to near-miss events may aid in the development of effective approaches to enhancing overall patient safety [ 19 , 20 ]. For instance, ElKhider and Savage [ 21 ] identified incidents that could have become hazardous if not addressed in a timely manner, offering healthcare decision-makers an opportunity to examine root causes and develop solutions, thereby improving patient safety. Thus, healthcare organizations should consider near misses as opportunities to cultivate a culture of safety, which is instrumental in ensuring high-quality and safe patient care.…”

Multi-level learning in public healthcare medical teams: the role of the social environment

“…When social processes are sub-optimised, status differences and hierarchies can perpetuate the occurrence of errors and more junior members of the team may be reluctant to challenge their senior colleagues (Lewis and Tully, 2009). Near misses may go unreported for fear of professional and departmental consequences (Elkhider and Savage, 2020). Communication problems may also arise due to status hierarchies between professionals (McGowan et al, 2013), which can impact on implementing practice changes (Tucker et al, 2007).…”