Motivational antecedents of incident reporting: evidence from a survey of nurses and physicians.
OBJECTIVE
Underreporting is a major issue when using incident reporting systems to improve safety in hospitals. Based on a psychological framework, this study investigated the motivational antecedents of the willingness to report into incident reporting systems in healthcare. Individual, organisational and system-related influences on the willingness to report incidents were investigated in a survey of physicians and nurses from five Swiss hospitals.


METHODS
The motivational antecedents were tested using structural equation modelling. The sample consisted of 818 respondents, 546 nurses and 230 physicians; the response rate was 32%. The willingness to report was assessed by using a self-report scale, validated with the self-reported number of reported incidents during the previous year.


RESULTS
The most important influence on the willingness to report was the transparency of the incident reporting system procedures to potential users, such as. knowing how and what kind of events to report. At the individual level, the perceived effectiveness of reporting was a relevant antecedent. At the organisational level, management support positively influenced the willingness to report. Different antecedents were found to be relevant for nurses and physicians.


CONCLUSIONS
Implications are discussed that open up alternatives for the design and implementation of incident reporting systems in healthcare. For example, the results of the study point to opportunities for making incident reporting systems more transparent and participatory and to allow for experience of how they actually improve patient safety.
ETH Zurich, SWITZERLAND; ypfeiffer@ethz.ch.
Yvonne
Y
Pfeiffer
Matthias
M
Briner
Theo
T
Wehner
Tanja
T
Manser
D001291:Attitude of Health Personnel; D006801:Humans; D008505:Medical Staff, Hospital / Q000523:psychology*; D009042:Motivation; D009741:Nursing Staff, Hospital / Q000523:psychology*; D015279:Organizational Culture; D061214:Patient Safety; D012308:Risk Management; D012380:Role; D011795:Surveys and Questionnaires