Fear prevents clinicians from reporting errors

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HCE Magazine talks to dozens of healthcare executives each month. Invariably, we hear about the valiant battles that are being waged by each of these executives against preventable errors within the care environment. Hearing about the initiatives they have passed and the innovative strategies that they’re instituting gives one hope for the continued advancement of quality care nationwide.

Therefore, it is greatly disturbing to read this article from HealthLeaders Media that outlines a report from the National Association for Healthcare Quality detailing how clinicians still aren’t reporting errors because they fear how their colleagues might react and the reprisals that might be levied against them within the workplace.

The report is quoted as saying, “In fact, as attention to creating a culture of safety in healthcare organizations has increased, so have concomitant reports of retaliation and intimidation targeting staff who voice concern about safety and quality deficiencies,” and this is backed up by one of the report’s compilers, American College of Physician Executives CEO Peter Angood, MD, who observed that “fear of retaliation is ‘very distinct and quite palpable in many organizations to the point that there is even a fear of making comment’ about the existence of the threat.”

Angood believes that some of this is leftover tradition from the old healthcare model that favored physicians over patients and the risk management programs that were designed to protect healthcare organizations from lawsuits.

“So in many places, not all, there is a fear from the administration and the risk management offices of receiving reports because it becomes discoverable information and the potential for legal liability,” Angood told HealthLeaders. “Once that tone is set it doesn’t take much for the workforce to recognize that reporting can be harmful for the institution. So they won’t report.”

What could change this workplace of fear? The trend of physicians becoming hospital employees, Angood says, which will maximize “awareness on the benefits of tackling errors and safety problems head on with improved reporting.”

And here is where the nature of the reporting system becomes important. It can’t be a “gotcha” system. It has to be a system based on rewards for positive outcomes and patient satisfaction. This will, according to the report, “create an even greater need for strong infrastructures to collect accurate data and address patient-safety concerns,” not to mention focusing attention on teams providing care rather than individuals.

For more on the report and Angood’s insights, we urge you to check out the HealthLeaders article. Suffice it to say, eliminating fear and intimidation—or bullying, to put it in a current-events context—will benefit everyone in healthcare from the executive suite on down.

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