Identifying barriers to incident reporting in a quaternary care hospital.

Abstract

This study aimed to explore the barriers to incident reporting among healthcare professionals in a quaternary care hospital in South India. A cross-sectional study was conducted from May to June 2023 among 1784 healthcare professionals selected using systematic random sampling. Data were analysed using descriptive statistics, χ² tests and analysis of variance. A total of 629 responded (35% response rate): 68 doctors (10%), 435 nurses (69%) and 126 allied health professionals (20%). Incident reporting was highest among allied health professionals (65%), followed by nurses (39%) and doctors (27%). However, nurses reported the highest absolute number of incidents (n=170). Types of incidents most frequently reported included medication related (n=92), patient safety (n=69) and patient care (n=42). The most common barriers were personal, particularly fear of punitive action (66% of allied health professionals, 36% of nurses and 15% of doctors), identity tracking concerns (56%, 40% and 38%, respectively) and perceived lack of anonymity. Differences in perceived barriers across groups were statistically significant (p<0.05). Individual-level barriers-especially fear of punitive action and lack of anonymity-continue to limit reporting despite established systems. Leadership must foster a non-punitive, confidential culture and improve feedback. While simplifying processes and expanding training may enhance participation, these strategies remain untested at our institution, serving instead as guidance for future quality improvement efforts.