Medical Error Reporting: Status Quo and Perceived Barriers in an Orthopedic Center in Iran

Abstract

Background: Medical error reporting is fundamental for improving patient safety. We surveyed healthcare professionals to evaluate their experience of adverse events witness and reporting, knowledge about adverse events, attitude toward own and colleagues' errors, and perceived barriers in reporting errors.

Methods: This cross-sectional study was conducted on healthcare professionals from May to October 2017 at Chamran hospital, which is the largest referral orthopedic center in southern Iran. The self-administered questionnaire comprised 32 items covering five domains: (1) demographic and professional characteristics, (2) medical error witness and reporting, (3) actual and perceived knowledge regarding type of events and the status of completed training courses, (4) attitude toward reporting one's own and colleagues' errors, and (5) perceived barriers in error reporting. Questionnaire validity and reliability was proven in our previous study.

Results: From a total of 210 participants, 164 returned completed questionnaires (response rate = 78.1%); 87 (53%) were physicians and 77 (47%) were nurses. Underreporting was common, particularly among physicians. Out of physicians and nurses, 57.1% and 49.4% had poor knowledge, respectively. Participants reported their own or colleagues' errors alike, but physicians tended to only provide verbal warning to their colleagues (36.8%), and nurses stated they would report the colleagues' errors, if it was serious (32.4%). Fear of blame and punishment and fear of legal ramification were the most important perceived barriers.

Conclusions: Improvements in current medical error registry system, implementing effective educational courses, and modifying the curricula for students seem to be necessary to resolve the problem of underreporting and poor knowledge level.

Keywords: Barriers; education; health personnel; knowledge; medical errors; patient safety; quality of healthcare.

Figure 1

(a and b). Rating to medical error reporting barriers by physicians and nurses, Organizational perceived barrier includes no feedback (q10), legal fear (q6), no anonymous (q3, q4) and, time consuming (q5); Personalize perceived barrier includes fear of blame (q7, q8), lack of knowledge (q1, q2, q9) and cultural (q11, q12, q13)