The influence of organizational culture, climate and commitment on speaking up about medical errors

Abstract

Aim: Speaking up about medical errors is an essential behaviour for nurses in pursuit of their goal of maintaining patient safety. This study was designed to understand how a hospital's culture and climate can impact a nurse's active behaviour in this important health care activity.Background: Research shows that while medical errors happen frequently, there is great variability on whether these errors are reported. As such, organizational culture, climate and commitment as well as employee perceptions associated with the reporting process were investigated to determine their impact on participants' intentions to speak up about medical errors. Methods:Focus groups and one-on-one interviews were used to collect these data and were analysed using content analysis. Results/KeyIssues: Nurses in the hospital perceive and understand both the benefits and barriers to reporting medical errors. Commonly reported benefits include patient safety, promoting education and awareness, and the improvement of internal processes or systems. Barriers include an inefficient reporting system and organizational influences such as perceived consequences and unequal status/position of the individual who made the error and the person reporting the error. Participants are aware that the organization believes that the responsibility to report medical errors falls to everyone. Conclusions: Results indicate that the organization's existing culture does not facilitate the reporting of medical errors and that the organizational climate interferes with the reporting process. Lastly, organizational commitment is not related to the perception of importance given to the reporting of medical errors by the hospital. Implications for Nursing Management: Nurses and nurse managers are an essential part of any hospital. In their role, they can effect change on the organization's culture and climate, but often do not realize the connection between organizational culture and patient safety. Results indicate that promoting organizational commitment to speaking up through the creation of a positive organizational culture can both promote speaking up about medical errors and increase patient safety. K E Y W O R D S organizational culture, patient safety, speaking up | 131 LEVINE Et aL.

Prevalence of medical errors and barriers to report among nurses and nursing students in Jordan: A cross‐sectional study

“…Previous studies congruently found fear of legal consequences to be the top reason for nonreporting MEs among nurses 10,14,21,22 in addition to lack of time, and lack of information and training regarding when and how to use incident reports. 22 Predictors of perceived prevalence of ME included being a bedside nurse and having higher experience.…”

“…This study aimed to examine the prevalence and types of MEs, and the perceived barriers to report MEs from the perspective of nurses and assess variations between nurses and nursing students. Due to the problem of the underreporting issue of MEs that was reported in the literature,10 we examined nurses' and nursing students' perspectives…”

Model of Organizational Commitment Applied to Health Management Systems

“…In fact, nurse manager capability has been associated with high emotional intelligence, which is also high amongst those in this role [174]. An organizational culture must be provided that enables nursing professionals to report medical errors [175]. Improving the quality of organizational culture, which affects the quality of work life, organizational commitment, job satisfaction, and employee turnover [176].…”

Barreiras para comunicação eficaz em saúde

“…Este mesmo motivo, em um outro estudo, inibiu enfermeiros de não relatarem erros de medicação, diante da crença que seus pares iriam julgar incompetência caso isso ocorresse (Hammoudi et al, 2018). Em reforço à importância dos relacionamentos Levine et al (2020), descrevem que o aprendizado dos profissionais da saúde é certamente o resultado de suas interações com outras pessoas.…”