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Massachusetts Health Policy Forum




Improving patient safety depends on a sophisticated understanding of what can jeopardize it. Reports of adverse patient events and "near misses" constitute valuable information that can foster that understanding. Knowing what has gone wrong in the past facilitates the search for systems improvements, which can prevent recurrence. Unfortunately, providers have been generally unenthusiastic about reporting medical error, whether from a sense of shame, from a fear of liability and institutional sanctions, or from anxiety about reputation and relationships with peers. This Issue Brief lays out the factors that may affect reporting, and explores the limited evidence about whether providers' confidentiality and liability concerns do in fact negatively affect their willingness to report, and if so, what might be done to improve the situation.



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