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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Using focus groups to understand physicians' and nurses' perspectives on error reporting in hospitals.

Donna B Jeffe1, William Claiborne Dunagan, Jane Garbutt

  • 1Department of Medicine, Washington University School of Medicine, St. Louis, USA. djeffe@im.wustl.edu

Joint Commission Journal on Quality and Safety
|October 8, 2004
PubMed
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Area of Science:

  • Medical error reporting
  • Patient safety
  • Healthcare quality improvement

Background:

  • Understanding physician and nurse perspectives on medical error reporting is crucial for increasing reporting rates in hospitals.
  • Identifying barriers to error reporting and exploring strategies to overcome them is necessary for improving patient safety.

Purpose of the Study:

  • To explore physicians' and nurses' perspectives on medical error reporting.
  • To identify barriers to medical error reporting.
  • To understand potential strategies for increasing medical error reporting.

Main Methods:

  • Nine focus groups were conducted with 49 staff nurses, 10 nurse managers, and 30 physicians.
  • Participants were recruited from 20 academic and community hospitals in the St. Louis metropolitan area.
  • Qualitative analysis of focus group transcripts was used to characterize participant perspectives.

Main Results:

  • Participants expressed uncertainty regarding the reporting of less serious errors or near misses, despite knowing to report serious adverse events.
  • Nurses demonstrated greater knowledge of error reporting procedures than physicians.
  • Common barriers included fear of reprisals, lack of confidentiality, time constraints, and insufficient feedback post-reporting. While some physicians doubted reporting benefits, both groups agreed on its role in improving patient safety through practice and policy changes.

Conclusions:

  • Establishing a culture of anonymous reporting, freedom from repercussions, and providing feedback on error reports can significantly promote error reporting.
  • These cultural shifts are essential for enhancing patient safety and improving healthcare quality.