Skip to main content
Article thumbnail
Location of Repository

Beyond Blame: cultural barriers to medical reporting

By Justin Waring

Abstract

The paper explores the attitudes of medical physicians towards adverse incident reporting in health care, with\ud particular focus on the inhibiting factors or barriers to participation. It is recognised that there are major barriers to medical reporting, such as the ‘culture of blame’. There are, however, few detailed qualitative accounts of medical culture as it relates to incident reporting. Drawing on a 2-year qualitative case study in the UK, this paper presents data gathered from 28 semi-structured interviews with specialist physicians. The findings suggest that blame certainly inhibits medical reporting, but other cultural issues were also significant. It was commonly accepted by doctors that errors are\ud an ‘inevitable’ and potentially unmanageable feature of medical work and incident reporting was therefore ‘pointless’. It was also found that reporting was discouraged by an anti-bureaucratic sentiment and rejection of excessive administrative duties. Doctors were also apprehensive about the increased potential for managers and non-physicians to engage in the regulation of medical quality through the use of incident data. The paper argues that the promotion of incident reporting must engage with more than the ubiquitous ‘culture of blame’ and instead address the ‘culture of medicine’, especially as it relates to the collegial and professional control of quality

Publisher: Elsevier
OAI identifier: oai:eprints.nottingham.ac.uk:737
Provided by: Nottingham ePrints

Suggested articles

Citations

  1. (1974). (1709) An Essay in
  2. (2000). An Organisation with a Memory,
  3. (2002). Barriers to incident reporting in a health care system”, Quality and Safety in Health Care,
  4. (1990). Basics of Qualitative Research: Grounded Theory procedures and techniques,
  5. (2001). Bristol Royal Infirmary Final Report,
  6. (2001). Building a Safer NHS for Patients,
  7. (1995). Controlling Health Professionals,
  8. (2001). Culture at work in aviation and medicine,
  9. (1999). Error in medicine”,
  10. (1979). Forgive and Remember,
  11. (2000). Human error – models and management”,
  12. (1991). Incidence of adverse events and negligence in hospitalized patients”,
  13. (1998). Maintaining professional identities: doctor’s responses to complaints”,
  14. (2003). Managing Maintenance Error,
  15. (1999). Managing the Risks of Organizational Accidents,
  16. (1998). Medicine as Culture,
  17. (2002). New directions in state and international professional occupations: discretionary decision-making and acquired regulation”,
  18. (2002). New Labour, Modernisation and the Medical Labour Process”,
  19. (2000). Organizational Culture and Identity,
  20. (1988). Organizational culture: origins and weakness”,
  21. (1970). Profession of Medicine :a study in the sociology of applied knowledge,
  22. (1999). Reasons for not reporting adverse incidents: an empirical study”,
  23. (1996). Regulating Medical Work,
  24. (2000). Reporting and preventing medical mishaps: lessons from non-medical near miss reporting”,
  25. (2004). Safety Agency (2003) 7 Steps to Patient Safety,
  26. (1995). The Incompetent Doctor,
  27. (1990). The NHS under new management,
  28. (1995). The quality of Australian healthcare study”,
  29. (2001). The reporting of adverse clinical incident – achieving high quality reporting: the results of a short research study,
  30. (1999). To Err is Human: Building a Safer Health System, DC:
  31. (1975). Training for Uncertainty”,

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.