Hospital culture contributes to low error-reporting rates

When we go to the hospital – be it for an emergency or for something more routine – we expect that we will be treated with the utmost care and respect. Sure, mistakes do sometimes happen, but we hope that they will be caught promptly and addressed in a respectful, professional manner.

Unfortunately, this hope is often misplaced. Increasingly, doctors and nurses in the United States are complaining about a culture of fear that prevents them from speaking up when they notice something amiss. They say that a trend toward corporatized health care has brought pressure to prioritize profits over care. Many express fears about losing their jobs if they speak out on systemic problems or report errors.

In a 2012 study by the Agency for Healthcare Research and Quality, more than 50 percent of survey respondents reported that they did not feel comfortable questioning the actions or decisions of higher-ranking staff members. Approximately 54 percent reported that their hospital’s response to error reporting felt too punitive. The survey involved approximately 600,000 doctors, nurses, pharmacists and medical staff members at more than 1,110 hospitals throughout the United States.

Overall, the study’s authors concluded that hospital staff members are reluctant to report errors because they believe that hospital leadership is more interested in enforcing hierarchies than in learning from mistakes and correcting problems.

The New Jersey Patient Safety Act

A penalizing culture and an unwillingness to learn and grow from mistakes can be extremely damaging in any workplace. But, in hospitals, the stakes are much higher – patients’ lives hang in the balance, and an unwillingness to identify and correct mistakes can result in major injuries and even wrongful death.

New Jersey has attempted to address this problem by creating a confidential error-reporting system that health care professionals can use to address patient safety risks without fear of retaliation. The New Jersey Patient Safety Act (PSA) requires health care facilities to report all “serious preventable adverse events.” The law defines those events as those that result in death, disability or serious injury and are linked to an error or system failure. Health care workers are also encouraged to report “near-misses” that could have resulted in significant patient harm.

In addition to reporting the nature of the mistake and its effect on patient safety, health care facilities are also required to describe the corrective actions they have taken and their plans to prevent similar accidents from happening in the future. Reports made under the PSA are confidential and generally cannot be used as evidence in medical malpractice lawsuits.

The PSA has gone a long way toward improving the safety culture in New Jersey hospitals. However, mistakes still happen, and it is important for injured patients to protect their rights when they do. When an injury can be traced back to negligence on the part of hospital staff, the victim has a right to seek compensation in a medical malpractice lawsuit.

If you or a loved one has been harmed by a medical mistake, a New Jersey medical malpractice attorney can evaluate your case and help you understand your options for moving forward.