From observation to action: a qualitative interview study of factors that influence the reporting of observations of unprofessional conduct in healthcare settings

从观察到行动:一项关于影响医疗机构中不专业行为观察报告的因素的定性访谈研究

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Abstract

BACKGROUND: Unprofessional behaviour in healthcare settings can undermine patient safety, erode team morale, and if not addressed, negatively impact organisational culture. Healthcare organisations rely on the voluntary reporting of such behaviours to identify and address these issues. Understanding the factors that influence reporting decisions is essential for pursuing and sustaining a culture of safety and respect. OBJECTIVE: To explore the motivations, experiences and attitudes of healthcare professionals who report incidents of perceived unprofessional behaviour through an organisational event reporting system. METHODS: A qualitative study was conducted involving semistructured interviews with 50 healthcare professionals who had submitted reports of unprofessional behaviour at the study site. Thematic analysis was used to identify recurring themes related to the reporters' motivations, reservations, knowledge of the reporting process and considerations for direct communication. RESULTS: Participants reported being motivated to report primarily by concerns about coworker mistreatment (52%) and patient safety (38%). While most participants (68%) expressed no reservations about reporting, some raised concerns about potential retaliation (32%). Most participants (82%) demonstrated an understanding of the reporting process, and over half (56%) indicated they had attempted to address the issue directly with the colleague involved before submitting a formal report. CONCLUSION: Healthcare professionals are motivated to report unprofessional behaviour primarily out of concern for their colleagues and patient safety. Addressing fears of retaliation and promoting transparent reporting processes are essential for fostering a culture of safety and encouraging the reporting of unprofessional conduct. Findings suggest that organisations should continue to emphasise both formal reporting systems and training for direct communication to address unprofessional behaviour effectively.

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