The Culture of Incident Reporting and Feedback: A Cross-Sectional Study in a Hospital Setting

A safety culture where incidents have been reported and feedback given is essential to detect and understand system failures. The aims of this study were to examine the culture of incident reporting and feedback (the incident culture) in a hospital setting, and the associations between the incident culture and other dimensions of the safety culture. A cross-sectional study was carried out with the instrument Hospital Survey on Patient Safety Culture (HSOPSC) within 16 units in six somatic hospitals at a Norwegian Hospital Trust. Units with identical specialities across the hospitals constitute a clinic. HSOPSC measures the health care personnel’s perception of the safety culture, seven safety dimensions at the unit level, three at the hospital level and four outcome measures. The outcome measures “Frequency of event reporting” and the dimension “Feedback and communication about error” were combined into the variable “incident culture”, score 1 5. A positive score was defined as ≥ 4.0. This study included 631 health care personnel. The mean score for the incident culture was 3.10 (SD 0.65) with significant differences between the clinics, and the hospitals. The strongest predictors for the incident culture were the dimensions “Communication openness” (linear regression slope B 0.470; 95% CI 0.398 to 0.543; p < 0.001), “Manager expectations and actions promoting safety” (B 0.378; 95% CI 0.304 to 0.453; p < 0.001), “Organisational learning and continuous improvement” (B 0.374; 95% CI 0.293 to 0.455; p < 0.001) and “Teamwork across hospital units” (B 0.360; 95% CI 0.261 to 0.459; p < 0.001). In this study, the incident culture needed improvements. To improve the incident culture, the attention may be directed towards developing and maintaining a culture of open communication, management that promotes safety, and a learning organisation and teamwork between the units.