Archer Gareth, Colhoun Alison
ST5 Cardiology and Clinical Research Fellow, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.
ST7 Anaesthetics, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.
J Eval Clin Pract. 2018 Apr;24(2):362-368. doi: 10.1111/jep.12849. Epub 2017 Nov 17.
RATIONALE, AIMS, AND OBJECTIVES: Previous studies have shown a lack of engagement in the reporting process. There is limited evidence about whether attitudes and behaviours of doctors in the UK towards incident reporting have changed following the events at Mid Staffordshire National Health Service Foundation Trust and the recommendations that followed. We conducted a relatively large survey of doctors, aiming to assess whether doctors recognised incidents and reported them accordingly, along with their behaviours towards reporting and their suggestions of how incident reporting may be improved.
A cross-sectional survey of doctors was undertaken in 11 hospitals in the north of England. The participants (n = 581) were invited to take part in an electronic questionnaire. Demographics were obtained, and engagement with the incident reporting process was assessed, including an estimate of the number of incidents which were witnessed but not actually reported. Factors which influenced reporting behaviours were recorded. Free-text comments were encouraged. A mixed method analysis of the responses was performed.
Doctors do not appear to be engaging with the incident reporting process-in particular, junior doctors. The main reason given for not completing forms was not having enough time (38.2% of respondents), primarily due to the length and complexity of forms. Many doctors, 43.7%, witnessed more than 5 incidents, but only 13.3% of doctors submitted more than 5 reports. Free text comments revealed 4 themes which impact upon reporting behaviours: organisational issues, form structure, a culture of blame, and a lack of feedback. Several suggestions for improvement were made.
Little has changed in the attitudes and behaviours of doctors. Improving incident reporting form structure to make it more user-friendly and improving feedback may engage doctors and lead to an improved safety culture. The way the medical profession reports serious and other incidents still needs to be improved.
原理、目的和目标：先前的研究表明，在报告过程中缺乏参与度。关于英国医生对事件报告的态度和行为在米德斯塔福德郡国民保健服务基金会信托基金事件及后续建议之后是否发生了变化，证据有限。我们对医生进行了一项规模相对较大的调查，旨在评估医生是否识别出事件并相应地进行报告，以及他们对报告的行为和关于如何改进事件报告的建议。
在英格兰北部的11家医院对医生进行了横断面调查。邀请参与者（n = 581）参与电子问卷调查。获取了人口统计学信息，并评估了对事件报告过程的参与度，包括对目睹但未实际报告的事件数量的估计。记录了影响报告行为的因素。鼓励提供自由文本评论。对回复进行了混合方法分析。
医生似乎没有参与事件报告过程，尤其是初级医生。不填写表格的主要原因是没有足够的时间（38.2%的受访者），主要是因为表格的长度和复杂性。许多医生（43.7%）目睹了5起以上的事件，但只有13.3%的医生提交了5份以上的报告。自由文本评论揭示了影响报告行为的4个主题：组织问题、表格结构、责备文化和缺乏反馈。提出了一些改进建议。
医生的态度和行为几乎没有变化。改进事件报告表格结构以使其更便于用户使用并改善反馈可能会促使医生参与并形成更好的安全文化。医疗行业报告严重事件和其他事件仍需改进。
