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Impact of system-level activities and reporting design on the number of incident reports for patient safety
  1. H Fukuda1,2,
  2. Y Imanaka1,
  3. M Hirose1,
  4. K Hayashida1
  1. 1Department of Healthcare Economics and Quality Management, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan
  2. 2Institute for Health Economics and Policy, Tokyo, Japan
  1. Correspondence to Professor Yuichi Imanaka, Department of Healthcare Economics and Quality Management, School of Public Health, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan; imanaka-y{at}


Background Incident reporting is a promising tool to enhance patient safety, but few empirical studies have been conducted to identify factors that increase the number of incident reports.

Objective To evaluate how the number of incident reports are related to system-level activities and reporting design.

Methods A questionnaire survey was administered to all 1039 teaching hospitals in Japan. Items on the survey included number of reported incidents; reporting design of incidents; and status for system-level activities, including assignment of safety managers, conferences, ward rounds by peers, and staff education. Staff education encompasses many aspects of patient safety and is not limited to incident reporting. Poisson regression models were used to determine whether these activities and design of reporting method increase incident reports filed by physicians and nurses.

Results Educational activities were significantly associated with reporting by physicians (53% increase, p<0.001) but had no significant effect on nurse-generated reports. More reports were submitted by physicians and nurses in hospitals where time involved with filing a report was short (p<0.05). The impact of online reporting was limited to a 26% increase in physicians' reports (p<0.05).

Conclusion In accordance with the suggestions by previous studies that examined staff perceptions and attitudes, this study empirically demonstrated that to decrease burden to reporting and to implement staff educations may improve incident reporting.

  • Patient safety
  • incident reporting
  • reporting systems
  • national survey
  • teaching hospital
  • health professions education

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  • Funding The work described in this article was funded in part by the Health Sciences Research Grants for the Research on Policy Planning and Evaluation from the Ministry of Health, Labor and Welfare of Japan and the Grant-in-aid for Scientific Research A from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the institutional review board at the Graduate School of Medicine of Kyoto University.

  • Provenance and peer review Commissioned; externally peer reviewed.