Reasons for under-reporting and strategies to improve reporting .
Reasons for underreporting were highlighted at the initial national-level consultative meeting and the pre-interventional phase KIIs and FGDs. Exemplifying quotes are presented below.
“Although we have a designated Directorate for Healthcare Quality and Safety, policies and guidelines, the HCWs’ negative attitudes of HCWs contribute a lot to the reporting of near-misses. They think, “Why should we report?” and “Reporting will highlight our mistakes.” If we want to improve reporting, we should include the importance of near-misses and reporting of those in the undergraduate and postgraduate curricular of HCWs,’ and they should be given a good orientation about these at the time of recruitment.” (DHQS- A)“At [an] institutional level, lack of staff (designated medical officers for hospital QMUs), and frequent transfers of trained staff are significant barriers to reporting, because to maintain a successful reporting system, there should be a designated person who can monitor, analyse and provide feedback on the reports. In addition, HCWs’ ignorance and negative attitudes are also barriers.” (DGH Avissawella- B).