Culture of Blame—An Ongoing Burden for Doctors and Patient Safety

Ognjen Brborović, Hana Brborović, Iskra Alexandra Nola and Milan Milošević
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Ognjen Brborović: University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Department of Social Medicine and Organization of Health Care, Zagreb 10 000, Croatia
Hana Brborović: University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Department of Environmental and Occupational Health and Sports Medicine, WHO CC for Occupational Health, Zagreb 10 000, Croatia
Iskra Alexandra Nola: University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Department of Environmental and Occupational Health and Sports Medicine, WHO CC for Occupational Health, Zagreb 10 000, Croatia
Milan Milošević: University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Department of Environmental and Occupational Health and Sports Medicine, WHO CC for Occupational Health, Zagreb 10 000, Croatia

IJERPH, 2019, vol. 16, issue 23, 1-11

Abstract: Introduction: Every procedure in healthcare carries a certain degree of inherent unsafety resulting from problems in practice, which might lead to a healthcare adverse event (HAE). It is very important, and even mandatory, to report HAE. The point of HAE reporting is not to blame the person, but to learn from the HAE in order to prevent future HAEs. Study question: Our aim was to examine the prevalence and the impact of culture of blame on health workers’ health. Methods: A cross-sectional study on healthcare workers at two Croatian hospitals was conducted using the Hospital Survey on Patient Safety Culture (PSC). Results : The majority of PSC dimensions in both hospitals were high. Among the dimensions, Hospital Handoffs and Transitions and Overall Perceptions of Safety had the highest values. The Nonpunitive Response to Error dimension had low values, indicating the ongoing culture of blame. The Staffing dimension had low values, indicating the ongoing shortage of doctors and nurses. Discussion : We found inconsistencies between a single-item measure and PSC dimensions. It was expected that Frequency of Events Reported (PSC dimension) relates to Number of Events Reported (single-item measure). However, in our study, the relations between these pairs of measures were different between hospitals. Our results indicate the ongoing culture of blame. Healthcare workers do not report HAE because they fear they will be punished by management or by law.

Keywords: patient safety culture; healthcare workers; healthcare adverse events (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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