Exploring the Causes of Non-Reporting of Medical Errors in Hospitals and Strategies to Encourage Reporting: A Qualitative Study (Content Analysis)

Abstract

Background and purpose: The occurrence of medical errors in healthcare centers is highly significant due to the sensitive nature of providing care and saving patients' lives. Failure to report such errors can result in both financial and moral harm to patients and have adverse effects on the healthcare system. Medical errors have significant clinical and economic consequences and can influence mortality rates. Despite the wide range of medical errors in healthcare delivery, the errors committed by medical staff—due to the close care relationship between them and the patient—are among the most complex issues in the management of treatment systems. Therefore, the purpose of this study was to explore the causes of non-reporting of medical errors in hospitals and methods of encouraging the reporting of such errors. Materials and methods: This qualitative study was conducted using semi-structured, in-depth individual interviews with a conventional content analysis approach. The goal was to identify the factors contributing to the non-reporting of medical errors in 1402 (Iranian calendar year). The study population included doctors, specialists, and providers actively involved in patient safety in the hospital. In other words, individuals with knowledge and valuable experience in this area were interviewed. Data collection was conducted using a semi-structured questionnaire, designed by reviewing the literature and with the assistance of expert professors for the interviews. Sampling was performed purposefully until data saturation was reached. Data saturation was achieved after interviewing 22 experts. After the interviews, items and sub-items were identified through content analysis. Results: Key factors contributing to the failure to report medical errors were identified in two themes, six categories, and 45 items. The extracted themes included organizational and management factors, as well as legal issues. Organizational and management factors encompassed organizational culture, communication, reporting, and monitoring, while legal factors involved the consequences of reporting and control mechanisms. In total, 38 solutions were proposed to encourage the reporting of medical errors. The experts' suggestions for strategies to promote error reporting were identified under two themes, six categories, and 38 items. The themes included organizational and management factors and legal issues. Organizational and management factors covered organizational culture, the reporting process, monitoring, and communication, while legal factors involved the consequences of reporting and control. Conclusion: Errors in medical procedures may occur due to the inherent nature and sensitivity of these procedures. However, it is essential that medical staff consider themselves obligated to minimize errors and reduce harm to patients. Studying the causes of non-reporting of medical errors and understanding the underlying reasons are critical for improving patient safety and the quality of healthcare services. This knowledge can assist policymakers and healthcare practitioners in making informed decisions about error reporting and in delivering higher-quality services to the public. Additionally, it is important to train medical teams on the various types of errors and how to appropriately address them.

Keywords

• hospital
• medical errors
• adverse events
• quality of healthcare
• never events