Readiness to report medical treatment errors: the effects of safety procedures, safety information, and priority of safety

Med Care. 2006 Feb;44(2):117-23. doi: 10.1097/01.mlr.0000197035.12311.88.


Background: Medical error reporting is an essential component of patient safety enhancement. However, increasingly, the literature points to a problem of underreporting of treatment errors, mainly as a result of the fear of malpractice lawsuits and limited formal data collection systems. Few studies, if any, have examined the influence of informal aspects of the organization, such as safety climate, on employees' willingness to report errors.

Objectives: This study investigated the relationship between safety climate aspects and personnel readiness to report treatment errors in different hospital departments.

Method: The model was tested in 3 hospitals (n = 632 in 44 medical departments of 3 types; internal medicine, surgery, and intensive care). Three safety climate aspects were measured using questionnaires: the way employees perceive the safety procedures, the safety information flow within their department, and the relative priorities given to safety in the department. Readiness to report was measured by tallying each department's annual number of treatment errors reported to the hospitals' risk management systems.

Results: Negative binomial regression analysis indicated that the more personnel perceive procedures as suitable and safety information as available, the higher was their willingness to report treatment errors. These relationships significantly differed depending on the department type.

Conclusions: Hospitals should take into account the perceptions of personnel regarding safety procedures and information and understand that these perceptions operate differently in different department types in their effect on the staff's willingness to report treatment errors.

MeSH terms

  • Attitude of Health Personnel
  • Documentation / standards*
  • Hospital Administration / methods*
  • Humans
  • Medical Errors / prevention & control
  • Medical Errors / standards*
  • Models, Organizational
  • Personnel, Hospital
  • Quality Assurance, Health Care / organization & administration
  • Risk Management / methods*
  • Safety / standards*