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Practical and Cultural Barriers to Reporting Incidents Among Health Workers in Indonesian Public Hospitals

Authors Dhamanti I, Leggat S, Barraclough S

Received 26 November 2019

Accepted for publication 25 March 2020

Published 3 April 2020 Volume 2020:13 Pages 351—359


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Inge Dhamanti,1– 3 Sandra Leggat,3 Simon Barraclough3

1Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia; 2Center for Patient Safety Research, Universitas Airlangga, Surabaya, Indonesia; 3School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia

Correspondence: Inge Dhamanti
Faculty of Public Health, Universitas Airlangga, C Campus, Mulyorejo, Surabaya 60111, Indonesia
Tel +628 2336099800
Email [email protected]

Purpose: This study investigated the practical and cultural barriers of reporting patient safety incidents in three accredited public hospitals in East Java, Indonesia.
Methods: This study employed a mixed methods approach using a convergent parallel design. We surveyed 1121 health workers and interviewed 27 managerial staff members from the sampled hospitals. A chi-square analysis was performed to evaluate differences in demographic factors, barriers to reporting, and practices of reporting between those who had reported an incident and those who had witnessed an incident but had not reported it. NVivo 11 software was used to perform the qualitative data analysis.
Results: This study had a 76.53% response rate. The quantitative evaluation identified significant differences in professions and work units and in participation in quality and safety training between the reporting group and the non-reporting group. The analysis of practical barriers displayed significant differences between the groups with the following responses: “did not know how to report,” “did not know where to report,” and “lack of feedback”. For cultural barriers, a significant difference was shown only for the response “did not want conflict.” In the qualitative assessment, most of the interview participants reported lack of knowledge and lack of socialization or training as practical barriers in reporting incidents. Furthermore, reluctance and fear to report were mentioned as cultural barriers by most of the interviewees.
Conclusion: Because there were conflicting findings in the barriers of reporting incidents, these barriers must be identified, discussed, and resolved by health workers and their managers or supervisors to improve incident reporting. Managers must foster open communication and build positive connections with health workers. Further research is necessary to focus on possible ways of addressing the barriers to reporting.

Keywords: practical barriers, cultural barriers, incident reporting, Javanese values, patient safety

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