International Journal for Quality in Health Care Advance Access originally published online on March 12, 2008
International Journal for Quality in Health Care 2008 20(3):184-191; doi:10.1093/intqhc/mzn004
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Attitudes toward the large-scale implementation of an incident reporting system
1 Centre for Clinical Governance Research, University of New South Wales, Australia
Objective. An electronic Incident Information Management System implemented system-wide by the Department of Health, New South Wales, Australia was evaluated. We hypothesized that health professionals (i) would support the system via utilization and favourable attitudes and (ii) that their usage and attitudes would vary according to profession with nurses being most, and doctors least, favourably disposed.
Design, setting and participants. An online, anonymous questionnaire survey of 2185 health practitioners.
Main outcome measures. Undertaking system training, satisfaction with training, reporting incidents, incident reporting rates since system introduction and attitude questions focusing on use, security and evaluation of the system and workplace safety cultures.
Results. The first hypothesis received partial support. The majority of respondents had undertaken training and rated it highly. Most had reported incidents and maintained their previous reporting levels. Most attitudes regarding using the system and its security were favourable. Mixed attitudes were held about workplace safety cultures and the value of the system. Deficiencies in quality of reporting, feedback on incident reports and resources to analyse incident data were problems identified. The second hypothesis was confirmed. Nurses were most, and doctors least, likely to undertake training, report incidents and express favourable attitudes. Allied health responses were intermediate to those of the other professions.
Conclusions. The system implementation was relatively successful, but more so with some professions. Problems identified indicated that expectations as to the goals achievable in the short term were optimistic, but these are amenable to planned interventions.
Keywords: electronic incident reporting, health professionals, patient safety, quality improvement, safety attitudes, systems change
Address reprint requests to: Joanne Travaglia, Research Fellow, Centre for Clinical Governance Research, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia. Tel: ++61 2 9385 2594; Fax: ++61 2 9663 4926; E-mail: j.travaglia{at}unsw.edu.au
Accepted for publication January 18, 2008.