Common Barriers to Reporting Medical Errors

Abstract

Background: Medical errors are the third leading cause of death in the United States. Reporting of all medical errors is important to better understand the problem and to implement solutions based on root causes. Underreporting of medical errors is a common and a challenging obstacle in the fight for patient safety. The goal of this study is to review common barriers to reporting medical errors.

Methods: We systematically reviewed the literature by searching the MEDLINE and SCOPUS databases for studies on barriers to reporting medical errors. The preferred reporting items for systematic reviews and meta-analyses guideline was followed in selecting eligible studies.

Results: Thirty studies were included in the final review, 8 of which were from the United States. The majority of the studies used self-administered questionnaires (75%) to collect data. Nurses were the most studied providers (87%), followed by physicians (27%). Fear of consequences is the most reported barrier (63%), followed by lack of feedback (27%) and work climate/culture (27%). Barriers to reporting were highly variable between different centers.

Figure 1

The study selection process using the PRISMA guideline.

Figure 2

Year of publication of the selected studies.

Figure 3

Percentage of studies where “fear of consequences” is an important barrier. Blue, yes, “fear of consequences” is an important barrier. Orange, no, “fear of consequences” is not an important barrier.