Barriers to incident reporting mentioned in literature
| Concept assigned to in framework | Thematic group of barriers and motivators | Example | Times mentioned | No of articles | References |
| Individual influences | |||||
| Personal attitude | Belief that reporting incidents is not part of one's job | “Unsure whose responsibility it is to report errors” | 7 | 5 | Evans et al, 200635; Merchant and Gully, 200538; Schectman and Plews-Ogan, 200639; Taylor et al, 200441; Vincent et al, 199947; Waring, 200545 |
| Personal attitude | Belief that IRS are not effective at enhancing patient safety | “Reporting errors does not make any difference” | 22 | 12 | Beasley et al, 200433; Coyle et al, 200534; Evans et al, 200635; Jeffe et al, 200436; Kingston et al, 200437; Merchant and Gully, 200538; Schectman and Plews-Ogan, 200639; Taylor et al, 200441; Uribe et al, 200242; Vincent et al, 199947; Waring, 200545; Wu et al, 20089 |
| Personal attitude | Fear of legal consequences | “Fear of lawsuits” | 10 | 9 | Beasley et al, 200433; Evans et al, 200635; Jeffe et al, 200436; Kingston et al, 200437; Merchant and Gully, 200538; Schectman and Plews-Ogan, 200639; Uribe et al, 200242; Waring, 200545 |
| Personal attitude | Fear of blame/disciplinary actions | “Concerned about being blamed” | 20 | 13 | Beasley et al, 200433; Evans et al, 200635; Garbutt et al, 200812; Jeffe et al, 200436; Karsh et al, 20068; Kingston et al, 200437; Schectman and Plews-Ogan, 200639; Vincent et al, 199947; Wakefield et al, 199910; Wakefield et al, 199644; Wild and Bradley, 200546; Waring, 200545 |
| Personal attitude | Fear that own competence may be questioned | “Concerned about being judged incompetent” | 9 | 7 | Coyle et al, 200534; Kingston et al, 200437; Schectman and Plews-Ogan, 200639; Taylor et al, 200441; Wakefield et al, 199910; Wakefield et al, 199644; Waring, 200545 |
| Personal attitude | Concerns about affecting others | “Afraid of making colleagues look bad” | 5 | 4 | Kingston et al, 200437; Schectman and Plews-Ogan, 200639; Taylor et al, 200441; Uribe et al, 200242 |
| Personal attitude | Concerns about unsupportive colleagues | “Co-workers may be unsupportive” | 2 | 2 | Evans et al, 200635; Vincent et al, 199947 |
| Personal attitude | Preference for alternative to incident reporting | “If I discuss the case with the person involved nothing else needs to be done” | 5 | 3 | Evans et al, 200635; Schectman and Plews-Ogan, 200639; Vincent et al, 199947 |
| Personal attitude | Perceived instrumentality of reporting | “People know what went wrong and how to avoid doing it again” | 3 | 2 | Jeffe et al, 200436; Wild and Bradley, 200546 |
| Personal attitude | Fear of negative consequences for the hospital | “Blame from the press” | 1 | 1 | Waring, 200545 |
| Subjective norm | Expectation of others | “Subjective norm has a significant effect on the intention to use an IRS” | 1 | 1 | Wu et al, 20089 |
| Organisational influences | |||||
| Psychological safety | Clinicians are not encouraged to report | “Faculty do not encourage residents to report medical events” | 3 | 3 | Braithwaite et al, 200813; Coyle et al, 200534; Vincent et al, 199947 |
| Perception of the IRS (IRS-related influences) | |||||
| Not knowing what to report/no clear definition of incident | “What to report needs to be clearly defined” | 17 | 13 | Beasley et al, 200433; Jeffe et al, 200436; Kingston et al, 200437; Merchant and Gully, 200538; Schectman and Plews-Ogan, 200639; Taylor et al, 200441; Tamuz et al, 200440; Uribe et al, 200242; Vincent et al, 199947; Waring, 200545; Wakefield et al, 199910; Wakefield et al, 199644; Wild and Bradley, 200546 | |
| Not knowing how to report an incident | “Unsure of reporting mechanism” | 9 | 6 | Evans et al, 200635; Jeffe et al, 200436; Schectman and Plews-Ogan, 200639; Uribe et al, 200242; Vincent et al, 199947; Wild and Bradley, 200546 | |
| Not knowing where to report an incident | “Don't know where CIRS forms are” | 6 | 5 | Beasley et al, 200433; Evans et al, 200635; Merchant and Gully, 200538; Schectman and Plews-Ogan, 200639; Vincent et al, 199947 | |
| Reporting form is not appropriate | “The form is too complicated and requires too many details” | 16 | 9 | Beasley et al, 200433; Evans et al, 200635; Braithwaite et al, 200813; Karsh et al, 20068; Kingston et al, 200437; Merchant and Gully, 200538; Schectman and Plews-Ogan, 200639; Taylor et al, 200441; Uribe et al, 200242 | |
| Reporting is (too) time-consuming | “Lack of time for reporting” | 12 | 10 | Coyle et al, 200534; Evans et al, 200635; Garbutt et al, 200812; Jeffe et al, 200436; Merchant and Gully, 200538; Schectman and Plews-Ogan, 200639; Uribe et al, 200242; Vincent et al, 199947; Wakefield et al, 199910; Wakefield et al, 199644 | |
| Reporting adds to workload | “Extra work involved in reporting” | 3 | 3 | Wu et al, 20089; Coyle et al, 200534; Uribe et al, 200242 | |
| Reporting not integrated in work | “Reporting interrupts the work progress” | 4 | 4 | Beasley et al, 200433; Coyle et al, 200534; Karsh et al, 20068; Vincent et al, 199947 | |
| No (appropriate) feedback is given on reported incidents | “Never heard feedback on quality improvement projects arising form reports” | 10 | 8 | Beasley et al, 200433; Braithwaite et al, 200813; Coyle et al, 200534; Evans et al, 200635; Garbutt et al, 200812; Jeffe et al, 200436; Kingston et al, 200437; Schectman and Plews-Ogan, 200639 | |
| Lack of trust in the anonymity/confidentiality of the IRS | “Don't feel confident the form is kept anonymous” | 12 | 9 | Beasley et al, 200433; Evans et al, 200635; Garbutt et al, 200812; Jeffe et al, 200436; Karsh et al, 20068; Kingston et al, 200437; Merchant and Gully, 200538; Schectman and Plews-Ogan, 200639; Wu et al, 20089 | |
| Analysis of the incidents not performed by competent persons | “Managers not able to sufficiently understand and interpret medical errors” | 3 | 3 | Beasley et al, 200433; Schectman and Plews-Ogan, 200639; Waring, 200545 | |
| Other influences | |||||
| Incident characteristics | Outcome | “No harm to patient” | 14 | 10 | Evans et al, 200635; Karsh et al, 20068; Merchant and Gully, 200538; Schectman and Plews-Ogan, 200639; Taylor et al, 200441; Uribe et al, 200242; Vincent et al, 199947; Wakefield et al, 199910; Wakefield et al, 199644; Wild and Bradley, 2005 46 |
| Not included (see scope of the framework) | Under-recognition | “Clinicians do not recognise that errors have occurred” | 2 | 2 | Wakefield et al, 199910; Wakefield et al, 199644 |
| Not included (see scope of the framework) | Not knowing that IRS exists | “Know that there is an IRS” | 2 | 2 | Vincent et al, 199947; Wild and Bradley, 200546 |
Concepts were only included in this table if we were able to assign at least one barrier mentioned in the literature to this concept.