Learning from mistakes in New Zealand hospitals: what else do we need besides "no-fault"?

Abstract

Aim: to obtain a more in-depth understanding of some of the key factors influencing medical error reporting behaviours of doctors in New Zealand.

Methods: A cross-sectional anonymous survey of 292 doctors in North Island was conducted over a period of 4 months.

Results: 128 doctors completed the survey (45% response rate). The results of the study suggest that (overall) most doctors feel they should report the occurrence of medical errors to both the patient and the hospital when they are anticipating major adverse events (long term/serious complications or mortality). However, when they are anticipating minor complications, not every doctor feels that they should report the error(s). This study also shows that doctors feel more comfortable to report errors to the patient than to report to the hospital (79% vs 21%). Furthermore, doctors selected the fear of losing patient's trust and the threat of public outcry most frequently as the most important reasons for their reluctance to report. Lastly, 86% of surveyed doctors felt that reporting the occurrence of errors to patients will decrease the likelihood of complaints being filed against them.

Conclusions: The study suggests that to learn from most of the mistakes, we need to have a system that not only facilitates the reporting of major errors but also encourages the reporting of minor ones. To mitigate the effects of key factors that prevent error reporting, we may benefit from making changes to how doctors are trained and how media reacts to the occurrence of errors in New Zealand hospitals.