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Conceptualising barriers to incident reporting: a psychological framework
  1. Y Pfeiffer,
  2. T Manser,
  3. T Wehner
  1. Center for Organizational and Occupational Sciences, ETH Zurich, Zurich, Switzerland
  1. Correspondence to Dr Yvonne Pfeiffer, Center for Organizational and Occupational Sciences, ETH Zurich, Kreuzplatz 5, Zurich CH-8032, Switzerland; ypfeiffer{at}


Background Incident reporting systems are widely considered effective instruments for learning from incidents. However, research shows that many incidents are not reported by healthcare providers.

Objective The lack of theoretical foundation in research on barriers to and motivators for incident reporting is addressed in this article, and a psychological framework of antecedents to staff's motivation (not) to report incidents is proposed.

Framework development Concepts relevant for clinicians' motivation to report incidents were identified in psychological literature. Additionally, a literature review was conducted to extract barriers to incident reporting and cluster them into thematic groups. Barriers and motivators influencing clinicians' willingness to report were integrated and identified as an indicator for actual reporting behaviour.

Conclusions The proposed framework provides a basis for guiding future empirical studies that will improve our understanding of what encourages and what hinders clinicians to report incidents and, consequently, of areas for interventions to enhance reporting behaviour.

  • Adverse events
  • barriers
  • incident reporting (systems)
  • under-reporting
  • willingness to report
  • healthcare quality improvement
  • near miss

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  • Funding This study was funded by the Commission for Technology and Innovation (KTI 8614.1 ESPP-ES) and by an internal research grant of ETH Zurich.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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