title: Incident reporting systems: a comparative study of two hospital divisions.
abstract: BACKGROUND
  Previous studies of incident reporting in health care organizations have largely focused on single cases, and have usually attended to earlier stages of reporting. This is a comparative case study of two hospital divisions' use of an incident reporting system, and considers the different stages in the process and the factors that help shape the process.
  
  
  METHODS
  The data was comprised of 85 semi-structured interviews of health care practitioners in general internal medicine, obstetrics and neonatology; thematic analysis of the transcribed interviews was undertaken. Inductive and deductive themes are reported. This work is part of a larger qualitative study found elsewhere in the literature.
  
  
  RESULTS
  The findings showed that there were major differences between the two divisions in terms of: a) what comprised a typical report (outcome based vs communication and near-miss based); b) how the reports were investigated (individual manager vs interdisciplinary team); c) learning from reporting (interventions having ambiguous linkages to the reporting system vs interventions having clear linkages to reported incidents); and d) feedback (limited feedback vs multiple feedback).
  
  
  CONCLUSIONS
  The differences between the two divisions can be explained in terms of: a) the influence of litigation on practice, b) the availability or lack of interprofessional training, and c) the introduction of the reporting system (top-down vs bottom-up approach). A model based on the findings portraying the influences on incident reporting and learning is provided. Implications for practice are addressed.
authors.affiliation: Population Health, University of Ottawa, 25 University Private, Ottawa, ON Canada K1N 7K4.
authors.forename: Tanya
authors.identifier: 0000-0002-0379-6548
authors.initials: T
authors.lastname: Hewitt
authors.affiliation: Telfer School of Management, University of Ottawa, 55 Laurier Avenue East, Ottawa, ON K1N 6N5 Canada.
authors.forename: Samia
authors.initials: S
authors.lastname: Chreim
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Ottawa, Civic Campus, 1053 Carling Avenue, Box 684, Administrative Services Building, Ottawa, ON K1Y 4E9 Canada ; Ottawa Hospital Research Institute Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Box 684, Administrative Services Building, Ottawa, ON K1Y 4E9 Canada.
authors.forename: Alan
authors.initials: A
authors.lastname: Forster
keywords: Internal medicine; Medical errors; Neonatology; Obstetrics; Patient safety; Qualitative research