One in three medical staff does not report mistakes made by their colleagues, even if there is a risk of patients’ safety being compromised, according to researchers at Radboud teaching hospital in Nijmegen.

Doctors told researchers that lack of evidence and the absence of an ‘open culture’ were the main reasons they were reluctant to raise the alarm, Trouw reports. A majority said they would welcome extra training and support.

Researchers in Nijmegen analysed five cases where patient care fell drastically short of standards, including some life-threatening situations.

‘Our impression is that many healthcare institutions and professional associations are doing more about this than before, but that is not always the experience of the staff,’ said researcher Jan-Willem Weenink. ‘They would like to see more attention paid in their training to dysfunctional situations.’

Fear

The team said that although there was a ‘culture of fear’ in some workplaces, with staff worried about the effect on their own position, this was not the main reason shortcomings were not reported.

Researcher Tijn Kool said it was more important to challenge the idea that staff needed hard evidence before they could report an error. ‘Even if there is no evidence, it’s better to raise the issue.’

The researchers also called for better support to be given to doctors who are the subject of a disciplinary inquiry to stop them becoming defensive or over-cautious, as this can also have a negative effect on patients.