Explanatory factors relating to medication error reporting among emergency medicine clinicians: A qualitative study

Objectives: We used an in-depth qualitative approach to investigate the factors that contribute to medication error (ME) reporting among emergency department (ED) clinicians. More specifically, we explored the explanatory factors relating to underreporting by the different staff involved in ED medication management, the underlying processes involved in clinician and manager responses to MEs, and programmatic factors that impede and facilitate ME reporting.

Methods: We applied a purposive maximum variation sampling to recruit interview participants in nursing, medical, and pharmacy roles. We conducted semistructured interviews based on an interview guide. We performed a thematic analysis of all data and developed a general content model.

Results: The developed model shows how the series of extracted themes—norms of reporting, reporting culture, and evaluation and feedback—affect one another. The theme norms of reporting were mainly influenced by clinicians’ knowledge and attitudes. The theme of reporting culture directly affected ME reporting. Evaluation and feedback affected all factors that contributed to ME reporting. Participants’ intention to report was mainly affected by the extent to which the reporting led to an obvious outcome. 

Conclusions: The comprehensive model of ME reporting provides guidance for healthcare leaders who strive to increase such reporting. The model encompasses broad concepts that are not limited to ME reporting and may be applicable to improving reporting for all kinds of medical errors.