Incident Reporting: A Curate's Egg?

Abstract

Background

Medical errors and adverse events are a source of concern to patients, practitioners and patient safety agencies across the world. The value of incident reporting as a means of improving patient safety has been questioned in the patient safety literature.

Aim

This paper provides a critical appraisal of incident reporting in the British National Health Service (NHS) as its prominence continues to grow at international, national and local levels. A number of implications are considered through reference to the available literature. Both national and local reporting systems will be discussed, before revisiting two key issues: the safety-information capacity of report data compared with medical record review, and the continued low reporting rate of medical staff.

Conclusions

While there are powerful drivers behind incident reporting, all of which have potentially beneficent rationales, a growing number of health-care professionals are beginning to question the usefulness of both reporting processes and outcomes. The authors suggest that an analysis of evidence of action taken to improve patient safety following the reporting of an incident would reveal low levels of activity and that, for many practitioners, the risk management activity is perceived as merely the act of reporting itself. Due to the continuing investment of organizational energy and finance into incident reporting, both at local and national level, it is prudent to reflect upon any uncertainties, so that further developments can be approached with confidence as part of the patient safety imperative.