Despite 20 years of quality and safety improvements, some healthcare providers still hold back from reporting concerning events, fearing retaliation and intimidation, according to a new report from the National Association for Healthcare Quality (NAHQ).
The NAHQ, along with 11 other organizations, is calling on hospitals to incorporate protective policies that encourage better reporting in an honest culture of safety.
In fact, the fear of retaliation is so "very distinct and quite palpable" that some hospital staff are afraid to mention the threat exists, Peter Angood, M.D., CEO of the American College of Physician Executives told HealthLeaders Media.
Such fears are nothing new. A February report from the Agency for Healthcare Research and Quality (AHRQ) found most health professionals are reluctant to report errors because they are afraid of a punitive hospital culture.
The fear of punitive actions stems from traditional risk management models, as well as hospitals aiming to make physicians happy, noted HealthLeaders. "On another level, if the reporting system is not oriented towards improving quality and transparently and safety, then the reporting system is perceived as a 'gotcha!'" Angood said.
To eliminate threats to better reporting of safety problems, the NAHQ report recommended hospitals focus on accountability, in particular, helping clinicians recognize their responsibility for quality and safety. Hospitals also must protect workers who voice concerns about safety and quality deficiencies and ensure their data and reports are comprehensive, transparent and accurate.
The NAHQ report also called on hospitals to immediately examine and respond to any concerns, using an attitude of "appreciative inquiry" when looking into quality and safety issues.
Moreover, new reimbursement models that reward high-quality care highlight the need for a nonpunitive environment with appropriate accountability, according to the report.