Blame Research Articles

Behavioural factors associated with fear of litigation as a driver for the increased use of caesarean sections: a scoping review

ObjectiveTo explore the behavioural drivers of fear of litigation among healthcare providers influencing caesarean section (CS) rates.DesignScoping review.Data sourcesWe searched MEDLINE, Scopus and WHO Global Index (1 January 2001 to...

Assessing Sorority Women’s Perceptions of Barriers to Reporting Sexual Assaults That Occur Within College Campus Greek Organizations

ABSTRACT Involvement in college campus Greek organizations is associated with an elevated risk of experiencing sexual assault victimization. Experiencing sexual assault victimizaiton is associated with myriad of consequences that could be mitigated by reporting the experience to friends, campus authorities, or police, yet researchers’ understanding of reasons why women participating in Greek organizations do not report sexual assaults committed by a fraternity member is understudied. Thus, the goal of this study was to assess perceived barriers to reporting a sexual assault committed by a member of a fraternity. Women associated with Greek organizations from two large universities in the south and southwestern region of the US (n = 235) completed an online survey about sexual assault. Participants were asked to describe why they thought women assaulted by a fraternity member would not report their experience. An inductive and deductive coding process suggested women perceived barriers to reporting across intrapersonal (e.g. feeling afraid/shame), interpersonal (e.g. sorority sisters would ostracize them), organizational (e.g. reporting would jeopardize Greek life), community (e.g. reporting on campus/police is challenging) and societal levels (e.g. victim blame culture). Findings suggest larger socio-cultural factors may influence whether women would report a sexual assault committed by a fraternity member. Collaboration between Greek organizations, campus Fraternity and Sorority advisors, and sexual assault prevention advocates could help to provide a supportive environment for women when sexual assaults occur.

Public inquiries, patient safety and the implementation gap

A decade on from the Francis report, avoidable patient harm continues to occur and we have continued to see new inquiries and reviews into serious patient safety scandals. A failure to listen to patients or learn from previous investigations, a corrosive blame culture, a lack of effective leadership and an unresponsive regulatory framework are alarming and often reported themes that we review here.

The Antifragile Radiologist

The Antifragile Radiologist

The Academic PMA....Supporting the Future Midwifery Workforce

Development of the A-EQUIP model followed recommendations suggesting that statutory supervision of midwifery, for a variety of reasons, was not fit for purpose.1,2 A culture of blame and accountability, poor teamwork and ineffective leadership were identified as key elements of failings in the previous midwifery supervision model.1,2 These were accepted by the Nursing and Midwifery Council (NMC) and statutory changes were made.3 The statutory changes meant that supervision and regulation of midwives should be divided with the NMC solely controlling all regulatory activity.1 This resulted in statutory midwifery supervision ceasing in April 2017 and changed to an employer-led model of support and supervision.4

Causes of Reduced Revenue Generation in Federal Staff Hospital (Fsh) Laboratory; Annex 111 Federal Capital Territory, Abuja

The healthcare delivery system has been criticized for its “culture of blame” in which culpability for failure has been attributed to the human elements of the system: The Study was designed to identify and ascertain reasons for low-revenue generation in Federal staff hospital (FSH) laboratory; annex 111, Abuja and to proffer solutions, as well as deliver health care that minimizes risks and harm to service users, including avoiding preventable injuries and reducing medical errors. According to World Health Organization (WHO), a well-functioning healthcare system requires a financing mechanism, well trained and adequately paid workforce, reliable Information on which to base decisions and policies, and well-maintained health facilities to deliver quality services and technologies. Out of a total number of two hundred (200) respondents interviewed using questionnaires, hundred and sixty (160) were received using the random sampling method. 41% of the respondents believed that there are no barriers to accessing the facility, 48.0% indicated a Lack of Knowledge, and 11.0% said proximity. The year 2017/2018 to 2019 report showed a tremendous improvement. Revenue generated and the number of patients for the year 2018 was to the tune of twenty-nine million, nine hundred and seventy-six thousand, six hundred and sixty naira only (₦29,976,660.00) and twelve thousand, seven hundred and twenty-six patients (12,726) respectively. In comparing the year 2017/2018, respectively, this Study concluded that for overall improvement of the quality and performance in the healthcare environment, there is a need for the development of new inter-organizational patterns of care delivery and complex multitier governance structures. Keywords: Federal staff hospital (FSH) laboratory, Health care, Knowledge. Preventable injuries, World Health Organization (WHO).

Leadership Style, Blame Culture, and Perceived Organizational Support for Patient Safety Incident Reporting at RSIA at Jakarta

The hospital is an integral part of a social and health organization which function is to provide comprehensive, curative and preventive services to the community. Patient safety is the right of the patient, the patient has the right to obtain his security and safety during the treatment period in the hospital. Based on data from patient visits at Private RSIA Type B at Jakarta, there were 50,842 outpatients and 2932 inpatients in 2020. In 2021 there was an increase for 54,794 outpatients and 3091 inpatients. The results of the incident reporting in 2020 contained 80 reports of patient safety incidents that occurred and there was a decrease to 74 reports in 2021. The incident report is a record of every event or situation that can result in or has potential to cause harm that should not have occurred. This study uses a quantitative approach with a causal design research design using a covariant-based Structural Equation Model (SEM), namely AMOS, aiming to analyze the effect that can increase Patient Safety Incident’s reporting in hospitals. This study used a sample of 143 hospital staff. Research results: Leadership style and blame culture have a significant positive effect on increase Patient Safety Incident’s reporting through perceived organizational support. based on the results of the measurement of probability values, R2 and CR using SEM. Based on the results of the study, the implications of this study indicated magnitude of the influence of leadership style and blame culture through perceived organizational support which can increase Patient Safety Incident’s reporting, marked by creating improvements, and providing support for changing the blame culture to a just culture in order to increase staff awareness to work in an orderly administration and orderly Standard Operating Procedure.

Exploring the Newspaper Representation on Victim-Blaming in Bangladesh: A Recent Case Study

The study investigates the depiction of victim-blaming culture in Bangladeshi newspapers in the context of a specific suicidal case, employing content analysis to explore the representation of the particular incident on a grander scale than previously thought. Using the “Social Representation Theory,” this research focuses on the representation of the victim in Bangladeshi newspapers and attempts to establish the blaming culture prevalent in the country through a specific instance. This mixed-methods study analyzes 27 selected news items regarding the particular case. Data is gathered from five major newspapers (The Daily Star, Prothom Alo, KalerKantho, Samakal, and DeshRupantor) and evaluated using a range of statistical methods. This study describes the victim’s linguistic representation in society through textual analysis of four major elements. It is discovered in this paper that the involvement of a well-known figure was the most concerning issue, but that the print media, specifically newspapers, attempted to conceal that involvement by focusing on other factors such as the victim’s lifestyle, occupation, and identity, all of which were found to be of great concern by selective newspapers, resulting in negative public opinion toward the victim. According to the authors, even if they are subjected to ownership pressures or pressures from other perpetrators, the national dailies of Bangladesh should portray the actual situation as accurately as possible. Keywords: explore, newspaper representation, victim-blaming, Bangladesh

Investigating the effect strength of positive risk-taking barriers on discharge decisions in occupational therapy intermediate care: A factorial survey

Introduction: Positive risk-taking in occupational therapy intermediate care is a requirement, yet little is known about how positive risk-taking barriers influence discharge decisions at different experience levels. Method: A factorial survey was used to investigate positive risk-taking barriers (Limited Capacity, Risk Averse Family, Blame Culture and No Support). Participants self-categorised their experience level into Novice or Semi-expert or Expert before analysing four vignettes relating to recommending a home discharge for an older adult. Data were analysed using Multiple Regression and One-Way Analysis of Variance. Results: Seventy-four participants responded to two hundred eighty-one vignettes. The barriers that reduced the likelihood to recommend a home discharge for an older adult were ‘No Support’, Novices (β = −0.315, p = 0.002), Semi-experts (β = −0.313, p = 0.001) Experts (β = −0.254, p = 0.009); ‘Limited Capacity’, Novices (β = −0.305, p < 0.003), Semi-experts (β = −0.254, p = 0.006) Experts (β = −0.376, p = 0.001) and ‘Blame Culture’ Semi-experts (β = −0.240, p = 0.010). Novices were found to be less likely to recommend a home discharge by comparison. Conclusion: The ‘Limited Capacity’, ‘No Support’ and ‘Blame Culture’ barriers had the strongest effect and Novices were less likely to recommend a home discharge overall. These findings could inform future research and pre-registration Occupational Therapy education.

Eight-year experience of maternal death surveillance in Morocco: qualitative study of stakeholders’ views at a subnational level

BackgroundSince 2009, Morocco has been implementing the Maternal Death Surveillance System (MDSS). The results obtained indicate significant regional variations in terms of implementation stage, completeness of maternal death reporting, and information use for action. The objective of this research is to better understand the contextual factors involved in the implementation process and use of MDSS, with a focus on the facilitators and barriers, as experienced by stakeholders in health regions. MethodsEvaluation research was conducted in 2017 based on a descriptive qualitative study using semi-structured in-depth interviews, in four out of the twelve health regions of Morocco. A total of thirty-one in-depth interviews were held with members of regional committees of maternal death reviews (RC-MDR) and other key informant staff. Interviews focused on participants’ views and their experiences with the MDSS since the introduction in 2009. We conducted thematic analysis relied on inductive and deductive approaches. Applying the Consolidated Framework for Implementation Research guided data analysis and reporting findings. FindingsEngaging leadership at all health system levels, regular training of district and regional MDSS coordinators and supportive supervision at a national level were the most important MDSS implementation facilitators. Reported barriers were essentially related to the review system: Irregular review meetings, blame culture, high turn-over of RC-MDR members, lack of analytical capacity to inform the review process and formulate recommendations, finally limited accountability for recommendation follow-up. While financial incentives boosted MDSS adoption, they were nonetheless a substantial barrier to its sustainability.ConclusionsThe MDSS is a complex process that requires taking numerous steps, including the commitment of multiple stakeholders with varying roles as well as information sharing across health system levels. Contextual factors that influence MDSS implementation at the sub-national level are to be considered. Horizontal and vertical communication about MDSS goals and feedback is crucial to strengthen stakeholders’ commitment, hence improving quality and use of MDSS. Furthermore, health regions should place emphasis on making high-quality recommendations in partnerships between the regional management teams, RC-MDR members and external stakeholders.

Organizational Safety Culture Transformation through Coaching

Organizational culture is simply known as 'the way we do things around here'. Culture is developed over time and evolves as people transit through the organization. It is an uphill task to transform organizational culture when this is not desirable. With regard to safety, it becomes even more important that the right mindset and behaviours are modelled across the organizational strata, as these are fundamental to keeping people, assets, and the environment safe. Personnel becomes wary of reporting incidents for fear of toppling the safety performance when the focus is placed on keeping safety track records. Another factor that contributes to underreporting is the attitude of the leaders while receiving 'bad news' of an incident. Excessive questioning, blame culture, and consequence management for failures create an environment of fear and inability to intervene in unsafe conditions.

Hospital managers’ views on the state of patient safety culture across three regions in Ghana

BackgroundImproving patient safety culture in healthcare organisations contributes positively to the quality of care and patients’ attitudes toward care. While hospital managers undoubtedly play critical roles in creating a patient safety culture, in Ghana, qualitative studies focussing on hospital managers’ views on the state of patient safety culture in their hospitals remain scanty.ObjectiveThis study aimed to explore the views of hospital managers regarding compliance to patient safety culture dimensions in the selected hospitals in the Bono, Greater Accra, and Upper East regions of Ghana.MethodologyThis was a qualitative exploratory study. A purposive sampling of all hospital managers involved in patient safety practices was conducted. The sampled managers were then invited to a focus group discussion. Twelve focus group discussions with each consisting of a maximum of twelve participants were conducted. The ten patient safety culture dimensions adapted from the Agency for Healthcare Research and Quality’s patient safety culture composite measures framed the interview guide. Deductive thematic content analysis was done. Lincoln and Guba’s methods of trustworthiness were applied to ensure that the findings are valid and reliable.FindingsPositive patient safety culture behaviours such as open communication, organisational learning, and strong teamwork within units, were an established practice in the selected facilities across Ghana. Lack of teamwork across units, fear of reporting adverse events, the existence of a blame culture, inconsistent response to errors, extreme shortage of staff, sub-standard handover, lack of management support with resources constrained the patient safety culture. The lack of standardised policies on reporting adverse events and response to errors encouraged managers to use various approaches, some resulting in a blame culture. Staff shortage contributed to poor quality of safety practices including poor handover which was also influenced by lateness to duty.ConclusionPrompt and appropriate responses by managers to medical errors require improvements in staffing and material resources as well as the enactment of standard policies across health facilities in the country. By so doing, hospital managers would contribute significantly to patient safety, and help build a patient safety culture in the selected hospitals.

Changing leadership, management and culture in mental health trusts

PurposeThis study aims to explore how leadership, management practices and organisational cultures have changed in low and high-performing mental health (MH) providers between 2015 and 2020 in the English National Health Service.Design/methodology/approachThe authors used a qualitative case study design comprising a purposeful sample of two low-performing and two high-performing MH providers, based on semi-structured interviews with 60 key informants (mostly internal to the organisation with some external informants from local Clinical Commissioning Groups).FindingsThe authors found major differences regarding leadership, management and organisational culture between low and high performing MH providers in 2015/2016, and that the differences had diminished considerably by 2019/20. In 2015/16, low performing providers were characterised by a “top-down” style of leadership, centralised decision-making and “blame cultures”. In contrast, the high performing providers were characterised as having more distributed, collaborative and inclusive styles of leadership/management, with open and supportive cultures. As the low performing providers changed and adapted their styles of leadership and management and organisational culture over the five-year period, they more closely resembled those of the high performing trusts.Originality/valueTo the best of the authors’ knowledge, this is the first study to explore the relationship between changing organisational factors and the performance of MH care providers. It provides evidence that it is possible for radical changes in leadership, management and organisational culture to be enacted over a relatively short period of time and that such changes may help low performing providers to turnaround their underperformance.

“Why do nurses do not report”: A qualitative study of underreported workplace violence (WPV) in emergency department (ED)

Violence is a serious problem against emergency nurses which negatively affects the quality of nursing care unit. Most emergency nurses have accepted violence as part of their work. So many violences were not reported for some reasons related of their experiences. The objective was to explore WPV based on the internal circumstances of the ED nurses. A descriptive phenomenological approach was conducted in this study by utilising in-depth interviews. There were eight ED nurses whom selected by purposive sampling. The collected data were thematic analysed by using Miles and Huberman technique. The study identified three themes, (1) Dilemma of nurses in reporting, (2) “ready or not you have to deal with it”, and (3) the iceberg phenomena. The finding illustrates the internal factors that influenced the nurses in reporting WPV. The study emphasised that hospitals should eliminate the “normalization” of violence to reduce the incidents, and moving from “blame culture” to “learning culture” in order to build “reporting culture”. Moreover, education and training program should be reinforced regarding all forms of unacceptable violence. Furthermore, top managers must protect and provide adequate support to the staff who experienced the violence.

Patient safety culture and its determinants among healthcare professionals at a cluster hospital in Malaysia: a cross-sectional study

ObjectiveTo assess the baseline level and mean score of every domain of patient safety culture among healthcare professionals at a cluster hospital and identify the determinants associated with patient safety...

Organisational failure: rethinking whistleblowing for tomorrow’s doctors

The duty to protect patient welfare underpins undergraduate medical ethics and patient safety teaching. The current syllabus for patient safety emphasises the significance of organisational contribution to healthcare failures. However,...

“At Risk” Adolescent Boys’ Engagement With an Employability Intervention: A Qualitative Exploration

The individualization of Not in Education, Employment, or Training (NEET) status has contributed to a culture of blame that frames adolescent boys’ transition into employment and economic independence. Drawing on Urie Bronfenbrenner’s ecological systems theory, we explored how adolescent boys categorized as “at risk” of becoming NEET engage with a school-based work-readiness intervention. We interviewed five adolescent boys aged 13–14 years about their experiences of the intervention. Using reflexive thematic analysis, three main themes were constructed: (1) challenge mediated by choice; (2) access to supportive relationships; and (3) recognizing personal development. The findings illustrate the interrelatedness of adolescent boys’ engagement with, and within, their environment; findings support a push to consider engagement as an ecological concept. We end with considerations for more ecologically sensitive approaches to work-related intervention and the assessment of adolescent boys’ “at risk” status.

Patient safety culture as perceived by operating room professionals: a mixed-methods study

BackgroundRoutine assessments of patient safety culture within hospitals have been widely recommended to improve patient safety. Experts suggested that mixed-methods studies can help gain a deeper understanding of the concept. However, studies combining quantitative and qualitative approaches exploring patient safety culture are still lacking. This study aimed to explore patient safety culture as perceived by operating room professionals of two university hospitals in Sousse, Tunisia.MethodsBased on a mixed-methods approach, a cross-sectional survey followed by semi-structured interviews were conducted over a period of two months (December 2019 to January 2020). This study took place in all the operating rooms of two public university hospitals in the district of Sousse, Tunisia. To collect data for this survey, the French version of the Hospital Survey On Patient Safety Culture was used. For interviews, 13 participants were selected purposively using a critical case sampling approach and a topic guide was prepared. Anonymity and confidentiality were respected.ResultsOverall, twelve operating rooms, with different surgical specialties, were included in the study. Survey feedback was provided by 297 professionals representing a response rate of 85.6%. Concerning patient safety culture, the 10 dimensions had low scores (below 50%) and were considered “to be improved”. The highest score was found in ‘teamwork within units’ (45%). Whereas, the lowest scores were allocated to ‘non-punitive response to error’ (22.9%), followed by “frequency of adverse event reported” (25.6%) and “communication openness” (26.3%). Per qualitative data, participants provided a more detailed picture of patient safety issues such as underreporting, absence of an effective reporting system, lack of freedom of expression, and an existing blame culture in operating rooms.ConclusionsThe findings of this study showed a concerning perception held by participants about the lack of a patient safety culture in their operating rooms. It seems essential to design, implement and evaluate strategies that promote a positive patient safety culture and obliterate punitive climate in operating rooms.

Nurses' Ethical Obligations Toward Unvaccinated Individuals.

Nurses' Ethical Obligations Toward Unvaccinated Individuals.

The Barriers and Enhancers to Trust in a Just Culture in Hospital Settings: A Systematic Review.

Healthcare workers wanting to report errors often encounter a culture of fear or blame. A just culture can improve patient safety by promoting safe and open communication, trust is hereby essential. We defined trust in a just culture when healthcare professionals believe that error communication is honest, safe, and reliable. In this study, we investigated barriers and enhancers to trust in error reporting in a just culture. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, Emcare, and Web of Science database were searched on June 21, 2021. Several factors were found to influence trust in error reporting in a just culture, namely, organizational factors, team factors, and experience. Trust depends on the management style, open information about error handling, a focus on patient safety instead of blaming an individual, a well-executed walk-round, a code of professionalism, and a departmental incident reporting system (organizational factors). A close relationship between employee and primary supervisor, with discussion of the nature of an error and ascribing clear roles to physicians in care teams, can be enhancers of trust in error reporting. Moreover, creating a mutual understanding of the challenges faced by professionals can enhance trust (team factors). Trust in error reporting is also influenced by a health professional's experience and training in patient safety. Factors such as a lack of confidence in clinical skills, more fear of shame/blame by less experienced workers, and knowledge of the existing error reporting system will influence a person's trust in error reporting (experience). This systematic review identified barriers and enhancers to trust in error reporting in a just culture. The barriers and enhancers can be divided into 3 main themes: organizational factors, team factors, and experience. Findings show that trust can be learned and created based on practical principles.