Factors contributing to under-reporting of patient safety incidents in Indonesia: leaders’ perspectives

Abstract

Background: Understanding the causes of patient safety incidents is essential for improving patient safety; therefore, reporting and analysis of these incidents is a key imperative. Despite its implemention more than 15 years ago, the institutionalization of incident reporting in Indonesian hospitals is far from satisfactory. The aim of this study was to analyze the factors responsible for under-reporting of patient safety incidents in Indonesian public hospitals from the perspectives of leaders of hospitals, government departments, and independent institutions. Methods: A qualitative research methodology was adopted for this study using semi-structured interviews of key informants. 25 participants working at nine organizations (government departments, independent institutions, and public hospitals) were interviewed. The interview transcripts were analyzed using a deductive analytic approach. Nvivo 10 was used to for data processing prior to thematic analysis. Results: The key factors contributing to the under-reporting of patient safety incidents were categorized as hospital related and nonhospital related (government or independent agency). The hospital-related factors were: lack of understanding, knowledge, and responsibility for reporting; lack of leadership and institutional culture of reporting incidents; perception of reporting as an additional burden. The nonhospital-related factors were: lack of feedback and training; lack of confidentiality mechanisms in the system; absence of policy safeguards to prevent any punitive measures against the reporting hospital; lack of leadership. Conclusion: Our study identified factors contributing to the under-reporting of patient safety incidents in Indonesia. The lack of government support and absence of political will to improve patient safety incident reporting appear to be the root causes of under-reporting. Our findings call for concerted efforts involving government, independent agencies, hospitals, and other stakeholders for instituting reforms in the patient safety incident reporting system.

Comparison of Patient Safety Incident Reporting Systems in Taiwan, Malaysia, and Indonesia

“…First, Indonesian hospitals may not give incident reports priority because there was no timeline in submitting the report to the external agency, because delays in completing the incident reports were identified as common problem in Indonesian hospitals. 30 Second, there might be a delay in analyzing the incident at the national level because the incident reported may be several months old, thus also delaying feedback from national level.…”

“…Previous research also revealed the absence of external incident reporting timeline did not have a specified deadline that resulted in delay of reporting incident at the national level. 30…”

Perceived implementation of patient safety compliance among nursing supervisors in military hospitals: a descriptive qualitative study

“…Patient safety incidents in Indonesia remain high (Larasati and Dhamanti, 2021). Although there are 2,877 accredited hospitals in Indonesia, the incidence of patient safety incidents is still 12 %, totaling 7,465 reports (Dhamanti et al, 2021). This figure comprises 38% near-missed events (NMEs), 31% no-harm events (NHEs), and 31% adverse events (AEs) (Tuck et al, 2014;Wau and Purba, 2019;Toyo et al, 2022).…”