Identifying barriers to incident reporting in a quaternary care hospital

Abstract

Aim This study aimed to explore the barriers to incident reporting among healthcare professionals in a quaternary care hospital in South India. Methodology 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. Results 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). Conclusion 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.