Cultural and associated enablers of, and barriers to, adverse incident reporting.

Aim: Following the introduction of an electronic Incident Information Management System (IIMS) in New South Wales, Australia, the authors investigated enablers and barriers to the use of IIMS and factors associated with increased, static and decreased reporting rates.

Methodology: An online and paper-based, anonymous survey of 2185 health practitioners collected information about their reporting behaviour and experiences of enablers/barriers: training, system accessibility, ease of use, system security, feedback, perceived value of IIMS and workplace safety culture.

Findings: The 79.3% of respondents who reported on IIMS were distinguished from non-reporters by having undertaken IIMS training and evaluating this highly. Users reporting more incidents post-IIMS were more likely than those with static or decreased reporting rates to evaluate their training highly and to have experienced all enablers. Users reporting fewer incidents were least likely to do so. The relative likelihood of the three reporting groups experiencing various enablers was similar. Those most frequently experienced by all groups were system security and accessibility. Barriers most frequently encountered were more culturally embedded-for example, poor workplace safety culture. The 'more' reporting group actually reported most, and the 'static' group least, incidents. LIMITATIONS/IMPLICATIONS: The sample was large but not randomly selected, which limits the generalisability of findings.

Practical Implications: Interventions to increase reporting should target provision of training that endorses and fosters conditions shown to enhance reporting rates.

Originality: Enablers to incident reporting have been shown to be associated not only with reporting per se but also with changes to reporting patterns and rates.