Rich, A;
Viney, R;
Griffin, A;
(2019)
Understanding the factors influencing doctors' intentions to report patient safety concerns: a qualitative study.
Journal of the Royal Society of Medicine
, 112
(10)
pp. 428-437.
10.1177/0141076819877542.
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Abstract
OBJECTIVES: To investigate doctors' intentions to raise a patient safety concern by applying the socio-psychological model 'Theory of Planned Behaviour'. DESIGN: Qualitative semi-structured focus groups and interviews. SETTING: Training venues across England (North West, South East and South West). PARTICIPANTS: Sampling was purposeful to include doctors from differing backgrounds and grades. MAIN OUTCOME MEASURES: Perceptions of raising a patient safety concern. RESULTS: While raising a concern was considered an appropriate professional behaviour, there were multiple barriers to raising a concern, which could be explained by the Theory of Planned Behaviour. Negative attitudes operated due to a fear of the consequences, such as becoming professionally isolated. Disapproval for raising a concern was encountered at an interpersonal and organisational level. Organisational constraints of workload and culture significantly undermined the raising of a concern. Responses about concerns were often side-lined or not taken seriously, leading to demotivation to report. This was reinforced by high-profile cases in the media and the negative treatment of whistle-blowers. While regulator guidance acted as an enabler to justify raising a concern, doctors felt disempowered to raise a concern about people in positions of greater power, and ceased to report concerns due to a perceived lack of action about concerns raised previously. CONCLUSIONS: Intentions to raise a concern were complex and highly contextual. The Theory of Planned Behaviour is a useful model to aid understanding of the factors which influence the decision to raise a concern. Results point to implications for policymakers, including the need to publicise positive stories of whistle-blowers and providing greater support to doctors.
| Type: | Article |
|---|---|
| Title: | Understanding the factors influencing doctors' intentions to report patient safety concerns: a qualitative study |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/0141076819877542 |
| Publisher version: | https://doi.org/10.1177%2F0141076819877542 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Guidelines, professional conduct and regulation, postgraduate medical education, medical error/patient safety, qualitative research |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > UCL Medical School |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10083855 |
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