title: A qualitative study of the intra-hospital variations in incident reporting.
abstract: OBJECTIVE
  To determine the relationship between variations in hospital incident reporting and the corresponding attitudes and participation of medical professionals.
  
  
  METHODS
  An in-depth qualitative case study using semi-structured interviews with hospital managers and clinicians. Twelve participants were theoretically sampled based on their involvement with clinical risk management and patient safety. Twenty-five medical physicians and four risk leads were selected from the specialist hospital departments of Obstetrics, Anaesthesia, General Surgery, Acute Medicine, and Rehabilitation. The data were analysed to develop a descriptive account of the intra-hospital variations in reporting and the associated attitudes of physicians.
  
  
  METHODS
  The research was conducted in a single acute National Health Service Hospital Trust in the English Midlands.
  
  
  RESULTS
  The qualitative data revealed significant variations in the intra-hospital organization of incident reporting between medical specialities that corresponded with the attitudes and participation of medical staff. Specifically, it was found that medical doctors were more inclined to report incidents where the process of reporting was localized and integrated within medical rather than managerial systems of quality improvement. Underlying these variations, it is suggested that medical reporting is more likely when physicians have greater control or ownership of incident reporting, as this fosters confidence in the purpose of reporting, in particular its capacity to make meaningful service improvements whilst maintaining a sense of collegiality and professionalism.
authors.affiliation: University of Manchester, Applied Social Science, Manchester, UK. justin.j.waring@man.ac.uk
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Waring
mesh_terms: D000761:Anesthesia Department, Hospital / Q000706:statistics & numerical data; D001291:Attitude of Health Personnel; D004739:England; D006779:Hospitals, Public / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008505:Medical Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data; D015279:Organizational Culture; D010814:Physical Therapy Department, Hospital / Q000706:statistics & numerical data; D036301:Qualitative Research; D012308:Risk Management / Q000706:statistics & numerical data*; D013222:State Medicine; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data