Developing strategies for creating an error reporting culture and assessing their effectiveness

Objective: This study was conducted to develop strategies for creating an error reporting culture in a training and research hospital and to assess their effectiveness. Method: The researchers carried out this study between the years of 2012 and 2017 in all units of a training and research hospital in Izmir. The first stage of this two-stage study was performed with a single group and the quasi-experimental research method using pre- and post-initiative model. The second stage was performed using the descriptive qualitative research method. The initiatives of this study included training, hanging up banners and posters, using social networking sites, notification system revision and patient safety symposium strategies. Sociodemographic and working characteristics forms, the Medical Errors Attitude Scale, an event/error reporting analysis form, a falling reporting form and a semi-structured interview form were used as data collection tools. The sample of this study after the initiative included 401 people who matched measurements before the initiative. In the qualitative stage, the researchers interviewed a total of 13 health care workers. Data were evaluated using descriptive statistics, significance test on the difference between two equivalents in dependent groups and content analysis. Results: This study found a statistically significant difference between measurements of health professionals' medical error attitudes before and after the initiative. It was determined that medical error reporting rates increased in the first six months after the initiative, and this increase continued in the second six months. According to the six-month reports before the initiative, medication event reporting, which is among the mostly reported medical error types, increased by 15 times in the first six months after the initiative and by 30 times in the second six months compared to the period before the initiative. The researchers found that medical error reports in the institution where this study was conducted increased by 10 times at the end of the first year. In the qualitative stage, three main themes were specified: training/informing for eliminating fear culture, which is an issue of prevention in reporting medical errors, expectations from managers and facilitator initiatives. Conclusion: Multiple strategies applied as part of developing strategies for creating an error reporting culture and assessing their effectiveness positively affected health professionals' medical error attitudes and increased error reporting rates. Moreover, opinions of participants about eliminating fear culture guided the strategies of this study and should guide further research. Keywords: nursing, medical error, patient safety, case reporting