SafetyInsights.org

This looked at the impact of organisational justice on the non-reporting of health information technology (HIT) failures related to patient safety.

HIT systems include a range of technologies and electronic systems that store, share and analyse an individual’s health data. The failures include a HIT system malfunction or defect that could or did unnecessarily result in harm to a patient.

The authors provide some background, saying that to date, much of the evidence looking at non-reporting have focused largely at the human interface (e.g. “human error”), whereas the impact of technology-related failures have been understudied, despite the introduction of HIT introducing “new types of safety incidents that arise from human-technology interaction or are caused by technology failure” (p2).

Organisational justice and specifically procedural justice describes “individuals’ perceptions that they have an opportunity to voice their views during decision-making processes and that the organization’s decision-making procedures are unbiased and consistent across persons and situations” (p2).

1,399 nurses were involved in the study. Although this study focused on nurses in healthcare, I think it’s worth considering the relevance of findings to other industries.

Results

Quite expectedly, high organisational justice was associated with a reduced likelihood of non-reporting if non-reporting occurred due to some specific reasons. Organisational justice reduced non-reporting:

• when reporting was too hard or took too much time
• because the reporting had no impact on the organization’s processes
• because the respondent was worried about the consequences
• because the respondent was not required to file a report

Justice wasn’t associated with non-reporting if the reason for non-reporting was due to a lack of access to a reporting system, because no actual harm was caused to the patient or for a host of other reasons.\

Also noted was that, compared to previous studies, this study found no evidence that a stressful environment or psychological strain would increase non-reporting when the effects of justice were factored into the modelling.

Overall, it’s concluded that non-reporting of HIT system-related safety incidents is less common in an environment of high organisational justice. This is expected, with the authors noting that “Lack of trust in the management and a blaming culture where individuals are criticized and punished for mistakes inhibits incident reporting (Hewitt et al., 2017). Conversely, reporting is more likely to occur when the organizational culture is supportive, trustworthy, and psychologically safe” (p1).

In my view: not only is treating people right and fostering an environment of mutual trust, justice and respect the ethical thing to do, it’s also, evidently, the smartest business choice and the safest course of action.

Shout me a coffee

Authors: Kia Gluschkoff, Anu Kaihlanen, Sari Palojoki, Elina Laukka, Hannele Hyppönen, Liisa Karhe, Kaija Saranto, Tarja Heponiemi, 2021, Safety Science

Study link: https://doi.org/10.1016/j.ssci.2021.105450

Link to the LinkedIn article: https://www.linkedin.com/pulse/reporting-health-information-technology-patient-ben-hutchinson