Barriers to incident notification in a regional prehospital setting.
Emergency Medicine Journal · 2010-06-26 · Qualitative study
Abstract
BACKGROUND: The identification and monitoring of critical incidents or adverse events and error reporting is a relatively new area of study in the prehospital setting. In 2005, we commenced a prospective descriptive study of the implementation of a Critical Incident Monitoring process in a rural/regional pre-hospital setting. The objective of the project was to describe the nature and incidence of errors detected in the management of prehospital trauma with the ultimate aim of identifying processes to reduce or mitigate such incidents. This paper describes the barriers to reporting critical incidents identified during the 3-year study. METHOD: This study used a qualitative approach involving the triangulation of a number of ethnographic methodologies, including unscripted focus groups, informal interviews and qualitative aspects of surveys utilised in a broader research project. Prevailing themes were fed back to participants in an iterative process to further explore perceptions and beliefs regarding these concepts. The final analysis of themes is descriptively presented. RESULTS: A number of barriers were identified and categorised into seven themes. These themes were; Burden of reporting, fear of disciplinary action, fear of potential litigation, fear of breaches of confidentiality and fear of embarrassment, concern that 'nothing would change' even if the incident was reported, lack of familiarity with process and impact of 'blame culture'. CONCLUSION: There are numerous barriers to reporting critical incidents. One of the key approaches which may alleviate many of the barriers to reporting is shifting to a systems based focus rather than an individual 'shame and blame' approach. The underlying barriers lie in the culture of the profession, and appear consistent across other health care disciplines.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Implementation · Rural & remote
Related articles
- Implementation evaluation of pre-hospital blood collection in regional Australia: a mixed methods study. (Australas Emerg Care, 2021)
- Best practices on blood and blood products for a prehospital hemorrhage protocol: consensus from the 2025 Canadian prehospital transfusion summit. (Scand J Trauma Resusc Emerg Med, 2026)
- Regional implementation of the stroke systems of care model: recommendations of the northeast cerebrovascular consortium. (Stroke, 2009)
- Barriers and Priorities for Strengthening Prehospital Trauma Care in Hawassa, Ethiopia. (J Surg Res, 2026)
- Paramedics in an emerging role; a reflexive thematic analysis of barriers and enablers to primary care innovation through a community of practice. (BMC Prim Care, 2026)
- The Feasibility and Safety of Prehospital Whole Blood Administration for Patients in Hemorrhagic Shock in Isolated Regions of Colorado: Assessment of the First 6 Months. (World J Surg, 2026)