Barriers and Motivators for Making Error Reports from Family Medicine Offices: A Report from the American Academy of Family Physicians National Research Network (AAFP NRN)

Abstract

Context:Reporting of medical errors is a widely recognized mechanism for initiating patient safety improvement, yet we know little about the feasibility of error reporting in physician offices, where the majority of medical care in the United States is rendered.Objective: To identify barriers and motivators for error reporting by family physicians and their office staff based on the experiences of those participating in a testing process error reporting study.Design: Qualitative focus group study, analyzed using the editing method. Setting: Eight volunteer practices of the American Academy of Family Physicians National Research Network.Participants: 139 physicians, nurse practitioners, physician assistants, nurses, and staff who took part in 18 focus groups.Instrument: Interview questions asked about making reports, what prevents more reports from being made, and decisions about when to make reports.Results: Four factors were seen as central to making error reports: the burden of effort to report, clarity regarding the information requested in an error report, the perceived benefit to the reporter, and properties of the error (eg, severity, responsibility). The most commonly mentioned barriers were related to the high burden of effort to report and lack of clarity regarding the requested information. The most commonly mentioned motivator was perceived benefit.Conclusion: Successful error reporting systems for physicians' offices will need to have low reporting burden, have great clarity regarding the information requested, provide direct benefit through feedback useful to reporters, and take into account error severity and personal responsibility.

Families as Partners in Hospital Error and Adverse Event Surveillance

“…This may be because families are available to provide patient safety information and may in fact have more opportunity to provide such reports than clinicians, who might be prevented from reporting by competing time demands. 34,35 We additionally found that 49% of family reported errors and 24% of familyreported AEs were not present in the medical record, consistent with prior studies. 14,[16][17][18] Based on other studies, patient and family safety-reporting rates are variable and appear related to mode of reporting.…”

“…Of these, 717 completed FSIs. Their median (interquartile range) age was 32.5 (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) years; 380 (53.0%) were nonwhite, 566 (78.9%) were female, 603 (84.1%) were English speaking, and 380 (53.0%) had attended college. Of 717 parents/caregivers completing FSIs, 185 (25.8%) reported a total of 255 incidents, which were classified as 132 safety concerns (51.8%), 102 nonsafety-related quality concerns (40.0%), and 21 other concerns (8.2%).…”

Perceptions of Doctors and Pharmacists towards Medication Error Reporting and Prevention in Kedah, Malaysia: A Rasch Model Analysis

“…Both pharmacists and doctors most difficult to agree that workload interferes with their ability to report medication errors. This is different from the findings of previous studies where the barriers to error reporting were due to being busy, extra work needed to do report and incident reports take time to complete [35,37,38]. The difference could be explained that work load might be less in the primary clinics in our study compared to the other studies.…”

The Effectiveness of Error Reporting Promoting Strategy on Nurse's Attitude, Patient Safety Culture, Intention to Report and Reporting Rate

“…이와 같이 오류보고는 환자간호의 일선에서 발생 하는 오류의 양적 분석을 가능하게 하여 환자에게 미치는 영향 및 추가비용 발생에 대한 자료를 생성하며, 그 내용을 바탕으로 기저원인과 특성을 파악할 수 있고 (Kohn, Corriagan, & Donaldson, 2000), 환자안전에 대한 의료인들의 경각심을 불러일 으킨다는 장점이 있는 (Elder, Graham, Brandt, & Hickner, 2007) 비용효과적인 오류 예방법이다 .…”

“…그러나 오류는 발생한 만큼 보고되지 않는 것이 사실이며, 오히려 많이 발생할수록 보고될 확률이 낮다는 지적도 있어 (Kagan & Barnoy, 2008), 오류보고에 관여하는 장애요소를 제거하고 촉진시킬 필요가 있다 (Elder et al, 2007) (Hughes & Lapane, 2006;Sexton, Thomas, & Helmreich, 2000). 그동안 경직된 조직 의 구조나 분위기는 오류의 발생에 유연하게 대처하지 못하게 하였으므로 (Kaissi, 2006), 오류보고에 대해 비평적이지 않은 조직문화가 조직원들 간의 신뢰를 형성하고 보고를 향상시키 는데 기여하는 것으로 나타났다 (Force et al, 2006) •부가설 1: 팀협동문화, 안전문화, 직무만족, 병원관리 및 업무환경에 대한 인식 점수가 유의하게 증가할 것이다.…”