P2B171: Evaluation of the Medical Error Reporting Culture in Pediatricians and Pediatric Residents Working in Ethiopia: A National Survey

Background: Medical error remains one of the main causes of morbidity and mortality worldwide. The burden of medical error is not well studied in Ethiopia, and minimal studies have assessed the culture of error reporting among physicians. However, there are increasing number of applications filed for investigation of possible medical errors by patients and families in recent years. Limited physician education and standardization of error reporting practices in hospital likely plays a part in the obstacles faced regarding error reporting in our country.

Methods: A national survey of Pediatric Residents and Pediatricians attending the Ethiopian Pediatric Society’s 24th Annual Conference on March 9 and 10, 2023 was conducted using a self-administered, previously validated questionnaire on medical error reporting culture (Alsafi 2011 and 2015). Data were checked, cleaned, and entered into SPSS for analysis. The magnitude and the association between the different variables in relation to the outcome was measured and a 95% confidence interval (CI) and P values below 0.05 was considered statistically significant.

Results: A total of 200 participants completed the survey (response rate 92% of conference attendees). The majority were male (51.5%). Residents outnumber attending in the study (53% Vs 47%). The mean age was 34.8±8.2 years. 75% worked in government hospitals. Individuals that work in referral or teaching hospitals accounted for 52% of the respondents. Additional demographics reported in Table 1.
Only a minority of participants agreed that errors were common (26.5%), or that they had personally encountered a serious error (17.5%) or near miss (23%) in practice (Figure 1a). Most felt a duty to report these errors to prevent complications (85.5%) and cause positive change (65%); and more than half (53%) disagreed that errors should not be reported if they do not result in harm (Figure 1b). Even though, many participants felt their hospitals made efforts to prevent errors from happening (46.5%), only a minority indicated that their hospital had a mechanism for reporting errors (26.5%), and many (40%) were unsure whether their hospital was receptive to ideas from staff around error prevention (Figure 1c). Most respondents (57.5%) worried their hospital would hold mistakes against them (Figure 1c). We defined “good” error reporting culture as scoring ≥80% using a 3-point scale on 12 questions; answers from only 25% of respondents met this threshold. Pediatricians who finished training had a 10.1-fold increase in their culture of error reporting when compared to residents (AOR = 10.1, 95% CI = 1.81-56.38, P-value = 0.008).

Conclusion: Ethiopian pediatricians and pediatric residents report a paucity of systems for error reporting in their hospitals and are fearful of repercussions of reporting these events. Opportunities exist to improve education around, standardize approaches to, and improve the culture of error reporting in Ethiopia.