Exploring the Accuracy of Near-miss Reporting: A Mixed-methods Study.

Area of Science:

• Patient Safety
• Healthcare Quality Improvement
• Risk Management

Background:

• Near-miss events are critical indicators for preventing adverse patient outcomes.
• Accurate classification of safety events is essential for effective quality improvement initiatives.

Purpose of the Study:

• To evaluate healthcare professionals' descriptions of near-miss events.
• To assess the validity of reported near misses using the World Health Organization (WHO) patient safety classification framework.

Main Methods:

• Retrospective analysis of 2805 near-miss reports from a tertiary hospital (2021-2024).
• Mixed-methods approach utilizing descriptive statistics and qualitative analysis based on WHO criteria.
• Structured decision-making process to classify events as near misses, adverse events, no-harm incidents, or reportable circumstances.

Main Results:

• 84% of reports were validated as true near misses, predominantly in medication safety.
• Significant misclassification occurred in patient care and workplace safety reports.
• Many events involving patient harm or reaching patients without harm were incorrectly labeled as near misses.

Conclusions:

• The pharmacy department demonstrates strong near-miss detection and reporting, highlighting pharmacists' role in patient safety.
• Gaps in understanding safety event taxonomy lead to inaccurate reporting and hinder resolution.
• A comprehensive, standardized near-miss reporting framework with clear definitions and feedback mechanisms is needed to enhance consistency and patient safety.