Medical errors in the United States are currently the third leading
cause of death, following heart disease and cancer, and significantly
contribute to the increasing cost of health care (Aljabari & Kadhim,
2021). Although the documentation of drug errors has improved with
the implementation of electronic systems, other medical errors
remain difficult to capture and still heavily rely on self-reporting
(Aljabari & Kadhim, 2021). Without a national system of error
reporting or incentives for data submission, the current voluntary
system will never be adequate to fully capture the extent and impact
of medical errors on quality of care (Wolf & Hughes, 2008).
Research by Aljabari & Kadhim (2021) identified seven barriers to
medical error reporting. The most prevalent barrier is the fear of
negative consequences, which includes blame, job loss, and legal
consequences (Aljabari & Kadhim, 2021). Studies have revealed that
approximately 45% of medical errors go unreported due to a fear of
negative outcomes and the lack of constructive support by an
employer (Alyahya et al., 2021). A second barrier is the lack of
feedback or negative feedback after an error occurs (Aljabari &
Kadhim, 2021). A third barrier is a work culture in which
administrators target individuals when errors occur instead of
analyzing system issues (Aljabari & Kadhim, 2021). A fourth barrier is
a lack of understanding what constitutes a medical error or the
importance of reporting the error (Aljabari & Kadhim, 2021). A fifth
barrier is the length of time it can take for clinical staff to complete
the documentation of errors, especially with a paper system (Aljabari
& Kadhim, 2021). A sixth barrier is the absence of a medical error
reporting system (Aljabari & Kadhim, 2021). A seventh barrier is
personal factors; studies show a lower error reporting rate among
younger workers, less experienced workers, and employees who
have been with an organization for only a short period of time
(Aljabari & Kadhim, 2021). Another thing to consider when examining
error reporting is that a bias exists toward not reporting errors that
are near misses or that produce no harm to the patient in many
organizations (Wolf & Hughes, 2008).
Leaders of health care organizations can eradicate blame, shame, and
finger pointing by building a culture focused on patient safety
(Alyahya et al., 2021). A blame culture focuses on the failures of
individuals, which has been linked to lower medical error reporting
rates (Alyahya et al., 2021). A safety culture views errors as
opportunities to examine and improve systems and fosters an open
reporting environment without fear of negative consequences
(Alyahya et al., 2021). A safety culture should empower employees to
report and fix system issues and create a work environment that
recognizes and rewards those who report errors (Aljabari & Kadhim,
2021). In addition, the implementation of a reporting system that
allows for anonymous reporting may eliminate the fear barrier
(Aljabari & Kadhim, 2021). Another area on which leaders should
focus is the type of reporting system implemented and the efficiency
in which an individual can complete a report; electronic systems are
proven to be more efficient and increase rates of error reporting
(Aljabari & Kadhim, 2021). Finally, the leading causes of medical
errors are high workloads, fatigue, and stress, which are correlated
with staff shortages, long shifts, and budget constraints (Alyahya et
al., 2021). Therefore, leaders must focus on reducing these negative
work conditions utilizing novel approaches to workforce structures,
such as reducing the nurse/doctor to patient ratio (Alyahya et al.,
2021).
Aljabari, S., & Kadhim, Z. (2021). Common Barriers to Reporting
Medical Errors. The Scientific World Journal, 2021.
Alyahya, M. S., Hijazi, H. H., Alolayyan, M. N., Ajayneh, F. J., Khader,
Y. S., & Al-Sheyab, N. A. (2021). The Association Between Cognitive
Medical Errors and Their Contributing Organizational and Individual
Factors. Risk Management and Healthcare Policy, 14, 415.
Wolf, Z. R. & Hughes, R. G. (2008). Error Reporting and Disclosure.
Agency for Healthcare Research and Quality. Retrieved
from: https://www.ncbi.nlm.nih.gov/books/NBK2652/
