*The translation of this article in French and Portuguese has been made through machine translation and has not been edited yet. we apologise for any inaccuracies.
Do healthcare professionals (HCPs) feel comfortable with medical errors? How self-reporting in healthcare helps to prevent medical errors and medical negligence?
M3 Global Research’s latest global survey, with a sample of over 3,700 HCPs, found that 45% feel uncomfortable reporting a “severe” medical error. We’ll share the full results of the survey after discussing some key themes around medical errors and self-reporting
What Is a Medical Error?
Critics of the Johns Hopkins study report argue that the analysis was flawed as there is no standardised method for collecting national statistics for incidence rates for deaths directly caused by errors.
One of the challenges is that there is no universally accepted definition of “what constitutes a medical error”. As a result, it becomes difficult to measure and analyse errors accurately.
In general terms, a medical error is “a preventable adverse effect of medical care, whether or not it is evident or harmful to the patient”. In other words, it´s a failure in medical planning or execution that contributes to an unintended preventable result. Examples include*:
- Failing to complete the intended plan of action or implementing the wrong plan
- An unintended act or one that fails to achieve the intended outcome
- Deviating from agreed processes, which may or may not result in harm
- When planning or performing a procedure, doing anything that causes an unintended consequence
It is important to distinguish the type of medical error being discussed, as not all medical errors are human errors. It may also refer to or be a combination of systematic errors, which is errors in system or process design, faulty installation or maintenance of equipment, or ineffective organizational structure.
Human errors can be divided into “medical mistakes” and “medical malpractice”. The latter refers to medical negligence, when a healthcare professional fails to follow recognised standards of care and causing preventable harm to a patient.
How a “medical error” is defined is both complex and significant, as it impacts the overall practice of medicine and patient safety. To be able to effectively prevent and learn from errors, it is argued that there must be a universal definition of “what constitutes a medical error”. Only then, can they be officially classified to improve patient safety.
How Can Self-Reporting in Healthcare Help Prevent Medical Errors?
Self-reporting in healthcare is when a healthcare provider voluntarily reports medical mistakes through a system provided by their employer. Whether the self-reporting takes place on paper, by phone, or digitally, the purpose is to create a record and prevent similar errors from happening again. This is done through root cause analysis and comprehensive reviews of the collected data. With insights from previous and repeated errors, new guidelines and processes can be introduced to reduce medical errors and medical negligence.
There are challenges with self-reporting systems however, as they rely on personal accountability and several other factors, as outlined by the Institute for Healthcare Improvement:
“ First, staff must recognize when errors occur. Second, the reporting system must be user-friendly, not difficult or time-consuming. Third, the organization must have a just culture, one that encourages and rewards reporting and focuses not on individual blame and punishment but rather on improving systems and processes.”
The results from M3´s internal survey show that 90% of healthcare professionals do feel influenced by their workplace culture and how they respond to medical errors and mistakes when self-reporting.
It is widely recognised that self-reporting of medical errors is impacted by fear of disciplinary action, the risk to job security, and the perceived humiliation of reporting errors. It is therefore essential that healthcare organisations appreciate this when developing self-reporting systems to prevent medical errors.
Recently, three large hospitals piloted a newly developed self-reported learning (SRL) system over the course of two to four years. The system encouraged physicians to self-report their medical errors, along with insights to prevent recurrence, for comprehensive review and improvement.
Although there were relatively few errors self-reported by physicians during the trial, it was deemed a success as it captured novel errors, provided a safe space to report those errors, and encouraged secondary insights into the causes of the errors.
Let us know what you think about this approach, by leaving a comment in the section below!
What Is Healthcare Professionals’ Experience of Self-Reporting Medical Errors?
To understand HCPs’ experience of self-reporting medical errors, M3 Global Research conducted an internal survey with 3,700 M3 panel members across 14 countries in Europe and USA, between July and September 2022.
Participants were asked a series of questions about what they consider to be “mild” and “severe” mistakes in healthcare and how they feel about reporting them. 70% of the respondents were physicians or nurses working mostly in hospitals, clinics, and individual or group practices. The remaining 30% are other health professionals such as pharmacists, and medical assistants, among others.
HCPs’ classification of medical mistakes:
- The majority of respondents consider “mild” medical mistakes to be harmless medical errors that do not cause any direct or substantial injury to the patient. Examples of these are administrative errors (46%) or communication issues (22%).
- “Severe” medical mistakes would be errors that may impact patient safety and health or worsen the patient’s prognosis or outcome. Examples include diagnosis or treatment errors (25%), failure to address abnormal findings (21%), or premature discharge from the ER (20%).
Here are the complete results.
*Please select your language
HCPs’ comfort level with self-reporting medical mistakes:
- 60% of respondents feel comfortable admitting to, and reporting a minor medical mistake after they have found a solution, and 50% would feel comfortable reporting the error even if they had not been able to resolve it.
- In the case of severe medical mistakes that they were able to resolve, respondents were divided in terms of whether they felt comfortable reporting them (49%), or uncomfortable, but reporting the error regardless (45%).
- 90% would report severe medical mistakes even if they weren’t able to resolve it.
- When it comes to reporting medical mistakes made by co-workers, 35% would feel uncomfortable reporting minor or severe medical errors made by their colleagues, but would do so to improve the outcome.
Workplace impact on HCPs’ self-reporting of medical errors:
- Almost 90% of respondents’ opinions of a healthcare workplace are influenced by how they respond to errors and mistakes.
- 74% agree that their workplace is supportive of medical error reporting.
- 69% of participants feel that their workplace responds and reacts unequally to self-reported medical mistakes, based on the individual’s healthcare profession.
There is a growing appreciation that the majority of errors are beyond clinicians’ control. Although each individual should take responsibility for their actions, and be held accountable, external factors do need to be taken into account. What impact do increasing workload and staff fatigue have on medical errors? To what extent do healthcare self-reporting systems promote a safe and transparent reporting culture? What role should the healthcare organisations themselves take? To find answers against medical negligence, public awareness, understanding, and open conversation amongst the medical community are required.
How do you feel about self-reporting medical errors and mistakes as a physician or medical negligence in general? Let us know by leaving a comment in the section below with your opinion!
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