Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 143 No. 4546 (2013)

Motivational antecedents of incident reporting: evidence from a survey of nurses and physicians

  • Yvonne Pfeiffer
  • Matthias Briner
  • Theo Wehner
  • Tanja Manser
DOI
https://doi.org/10.4414/smw.2013.13881
Cite this as:
Swiss Med Wkly. 2013;143:w13881
Published
03.11.2013

Abstract

QUESTIONS UNDER STUDY: Underreporting is a major issue when using incident reporting systems to improve safety in hospitals. Based on a psychological framework, this study investigated the motivational antecedents of the willingness to report into incident reporting systems in healthcare. Individual, organisational and system-related influences on the willingness to report incidents were investigated in a survey of physicians and nurses from five Swiss hospitals.

METHODS: The motivational antecedents were tested using structural equation modelling. The sample consisted of 818 respondents, 546 nurses and 230 physicians; the response rate was 32%. The willingness to report was assessed by using a self-report scale, validated with the self-reported number of reported incidents during the previous year.

RESULTS: The most important influence on the willingness to report was the transparency of the incident reporting system procedures to potential users, such as. knowing how and what kind of events to report. At the individual level, the perceived effectiveness of reporting was a relevant antecedent. At the organisational level, management support positively influenced the willingness to report. Different antecedents were found to be relevant for nurses and physicians.

CONCLUSIONS: Implications are discussed that open up alternatives for the design and implementation of incident reporting systems in healthcare. For example, the results of the study point to opportunities for making incident reporting systems more transparent and participatory and to allow for experience of how they actually improve patient safety.

References

  1. Reason J. Human error. New York: Cambridge University Press; 1990.
  2. Weick KE, Sutcliffe KM. Managing the unexpected: Assuring high performance in an age of complexity. San Francisco: Jossey-Bass; 2007.
  3. Pronovost PJ, Thompson DA, Holzmueller CG, Lubomski LH, Dorman T, Dickman F, et al. Toward learning from patient safety reporting systems. J Crit Care. 2006;21:305–15.
  4. Kaderli R, Pfortmueller CA, Businger AP. Healthcare quality management in Switzerland – a survey among providers. Swiss Med Wkly. 2012;142:1–9.
  5. Barach P, Small SD. Reporting and preventing medical mishaps: lessons from non-medical near miss reporting systems. British Medical Journal. 2000;320(7237):759–63.
  6. Pfeiffer Y, Manser T, Wehner T. Conceptualising barriers to incident reporting: A psychological framework. Quality and Safety in Healthcare. 2010;19:e60:1–10.
  7. Uribe CL, Schweikhart SB, Pathak DS, Dow M, Marsh GB. Perceived barriers to medical-error reporting: an exploratory investigation. J Healthc Manag. 2002;47(4):263–79.
  8. Wild E, Bradley H. The gap between nurses and residents in a community hospital’s error-reporting system. Jt Comm J Qual Patient Saf. 2005;31(1):13–20.
  9. Braithwaite J, Westbrook M, Travaglia J. Attitudes toward the large scale implementation of an incident reporting system. International journal for quality in health care. 2008;20(3):184–91.
  10. Kingston MJ, Evans SM, Smith BJ, Berry JG. Attitudes of doctors and nurses towards incident reporting: a qualitative analysis. Med J Aust. 2004;181(1):36–9.
  11. Fishbein M, Ajzen I. Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. MA: Addison-Wesley: Reading; 1975.
  12. Beasley JW, Escoto KH, Karsh BT. Design elements for a primary care medical error reporting system. WMJ. 2004;103(1):56–9.
  13. Jeffe DB, Dunagan WC, Garbutt J, Burroughs TE, Gallagher TH, Hill PR, et al. Using Focus Groups to Understand Physicians’ and Nurses’ Perspectives on Error Reporting in Hospitals. Jt Comm J Qual Saf. 2004;30(9):471–9.
  14. Zhao BIN, Olivera F. Error reporting in organizations. The Academy of Management Review. 2006;313(4):1012‒30.
  15. Garbutt J, Waterman AD, Kapp JM, Dunagan WC, Levinson W, Fraser V, et al. Lost Opportunities: How Physicians Communicate About Medical Errors. Health Affair. 2008;27(1):246–55.
  16. Karsh B-T, Escoto KH, Beasley JW, Holden RJ. Toward a theoretical approach to medical error reporting system research and design. Appl Ergon. 2006;37(3):283–95.
  17. Wu AW, Pronovost P, Morlock L. ICU incident reporting systems. J Crit Care. 2002;17(2):86‒94
  18. Charng H-W, Piliavin JA, Callero PL. Role Identity and Reasoned Action in the Prediction of Repeated Behavior. Social Psychology Quarterly. 1988;51(4):303–17.
  19. Callero PL. Role-identity salience. Soc Psychol Quart. 1985;48(3):203–15.
  20. Piliavin JA, Grube JA, Callero PL. Role as Resource for Action in Public Service. J Soc Issues [Internet]. 2002;58(3):469–85. Available from: http://dx.doi.org/10.1111/0022-4537.t01-1-00027
  21. Crant JM. Proactive Behavior in Organizations. Journal of Management [Internet]. 2000;26(3):435–62. Available from: http://jom.sagepub.com/cgi/content/abstract/26/3/435
  22. Edmondson A. Psychological Safety and Learning Behavior in Work Teams. Admin Sci Quart [Internet]. Johnson Graduate School of Management, Cornell University; 1999;44(2):350–83. Available from: http://www.jstor.org/stable/2666999
  23. Carmeli A. Social Capital, Psychological Safety and Learning Behaviours from Failure in Organisations. Long Range Plann [Internet]. 2007;40(1):30–44. Available from: http://www.sciencedirect.com/science/article/B6V6K-4N3X4TY-1/2/1e7d6ebad70f577121976eb085d5ae4f
  24. Carmeli A, Gittell JH. High-quality relationships, psychological safety, and learning from failures in work organizations. Journal of Organizational Behavior. 2009;30(6):709–29.
  25. Firth-Cozens J, Mowbray D. Leadership and the quality of care. Qual Saf Health Care. 2001;10(Suppl II):ii3–ii7.
  26. Flin R, Yule S. Leadership for safety: industrial experience. Qual Saf Health Care. 2004;13(suppl_2):ii45–51.
  27. Hofmann DA, Morgeson FP. Safety-Related Behavior as a Social Exchange: The Role of Perceived Organizational Support and Leader-Member Exchange. Journal of Applied Psychology. 1999;84(2):286–96.
  28. Evans SM, Berry JG, Esterman AJ, Selim P, O’Shaughnessy J, De Wit M. Attitudes and barriers to incident reporting: a collaborative hospital study. Qual Saf Health Care. 2006;15:39–43.
  29. Merchant RN, Gully PM. A survey of British Columbia anesthesiologists on a provincial critical incident reporting program. Can J Anesth. 2005;52(7):680–4.
  30. Wu JH, Shen WS, Lin LM, Greenes RA, Bates DW. Testing the technology acceptance model for evaluating healthcare professionals’ intention to use an adverse event reporting system. Int J Qual Health Care. 2008;20(2):123–9.
  31. Schectman JM, Plews-Organ ML. Physician perception of hospital safety and barriers to incident reporting. Jt Comm J Qual Patient Saf. 2006;32(6):337‒343.
  32. Edmondson AC. Learning from mistakes is easier said than done: group and organizatiional influences on the detection and correction of human error. J Appl Behav Sci. 1996;32(1):5–28.
  33. Naveh E, Katz-Navon T, Stern Z. Readiness to report medical treatment errors. Medical Care. 2006;44(1):117–23.
  34. Grube JA, Piliavin JA. Role Identity, Organizational Experiences, and Volunteer Performance. Pers Soc Psychol B. 2000;26(9):1108–19.
  35. Kline RB. Principles and practice of structural equation modeling. 2nd ed. New York: Guilford Press; 2005.
  36. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling. 1999;6:1–55.
  37. Coyle YM, Mercer SQ, Murphy-Cullen CL, Schneider GW, Hynan LS. Effectiveness of a graduate medical education program for improving medical event reporting attitude and behavior. Qual Saf Health Care. 2005;14(5):383–8.
  38. Benn J, Koutantji M, Wallace L, Spurgeon P, Rejman M, Healey A, et al. Feedback from incident reporting: information and action to improve patient safety. Quality and Safety in Health Care. 2009;18(1):11–21.
  39. Runciman WB, Merry AF, Tito F. Error, Blame, and the Law in Health Care - An Antipodean Perspective. Annals of Internal Medicine. 2003;138(12):974–80.
  40. Lawton R, Parker D. Barriers to incident reporting in a healthcare system. Qual Saf Health Care. 2002;11(1):15–8.