Barriers to incident reporting among doctors and nurses in a Specialist Government Hospital in the state of Kedah, Malaysia

Abstract

Context: Barriers which cause underreporting of incidents among doctors and nurses have been explored in various scholarly literatures abroad. However, less is known about the barriers to incident reporting in our current Malaysian health care system. Objective: To study the contributions of barriers such as culture of blame, the occupational hierarchy in health care system and the burden of effort to incident reporting among doctors and nurses in a specialist government hospital. Secondly, to determine whether these barriers differ among the practitioners. Method: All the doctors (92) and nurses (282) from four clinical departments (Surgery, General Medicine, O&G and Anaesthesia) in a hospital with specialists in the state of Kedah were invited to participate as the respondents in this study. Questionnaires were distributed to all of the identified participants. A total of 317 doctors and nurses participated (84.8% return rate). Results: Twenty one percent of underreporting of incidents was due to fear of blame and forty one percent of incident underreporting resulted from differences in hierarchy in the organization. Nevertheless, sixty three percent of incident underreporting was because there was too much effort needed to report. Fifty two percent of nurses did not report trivial incidents and about sixty percent of them did not know what to report. Approximately sixty seven percent of nurses did not report if the ward was busy. Conclusion: To ensure a successful incident reporting system, the effort in reporting any incident need to be addressed. On the other hand, health care providers would be more willing to report if they were supported by their co-workers and supervisors. Hence, a supportive working environment is important to ensure more incidents to be reported.