Patient safety study reveals reasons why GPs underreport incidents

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New research by Swansea University academics into patient safety in primary care has shown that GPs can be reluctant to report patient safety errors, are selective in what they report and new reporting systems are needed to address these issues.

Dr David ReaDr David Rea, from the College of Human and Health Sciences in their report published in Health and Social Care in the Community, also found that GPs are not confident that patient safety error reports are read, learnt from or acted upon.

Dr Rea said: “Large numbers of errors are likely in primary care settings, which is not surprising, given that this is where most patient contact occurs. However, patient safety is of growing concern in healthcare and so the focus of the study was to find out why there is significant under-reporting of patient safety errors in primary care.”

The research looked at a sample of 17 GP practices and found the main barriers for GPs in reporting safety errors were:

  • Insufficient time to report errors
  • Lack of clarity over what was a significant event that required to be reported
  • Lack of feedback from the Health Board
  • Fear of blame
  • Damage to reputation  
  • Impact on patient confidence

Dr Rea said: “The main barriers to reporting within the practice included the time it took to report and discuss an incident, while blame and perceived damage to reputation and patient confidence was feared, especially in this competitive environment. However other barriers to reporting incidents included a lack of clarity over who to report to and what the information would be used for”.  

Reporting of errors is supposed to facilitate learning, so it is of concern that this research showed that GPs were deterred by the lack of feedback about what lessons were being learnt from errors: they said they would be more willing to report if the incident reporting process was more supportive and time was allocated to discuss incidents.

Dr Rea said: “The study has shed light on GPs’ perceptions of the value of reporting, and the variation arising from selective reporting. It also raises questions about the effectiveness of reporting processes."