fety (73 percent). More than 80 percent felt that the names of both the hospital and the involved professionals should be kept confidential, although respondents from states with mandatory public disclosure systems were more willing than respondents from the other states to release the hospital name (22 percent vs. 4 to 6 percent).

When presented with hypothetical clinical vignettes, more than 90 percent of hospital leaders said their hospital would report incidents involving serious injury to the state, but far fewer would report moderate or minor injuries, even when the incident was of sufficient consequence that they would tell the affected patient or family.

"In the hospital setting, executive leaders influence institutional policy and foster norms for their employees. These individuals believe that existing state reporting standards fail in some cases to provide clear guidance on what should be reported and that mandatory reporting systems with public disclosure may actually discourage internal reporting, lead to lawsuits, and impart little benefit to patient safety. Hospital leaders, of course, have their own institutional biases, and there is some evidence that hospitals that become accustomed to transparency may eventually grow to be more accepting of it. However, if hospital leaders continue to harbor negative views of reporting, it is unlikely that state mandatory reporting systems will be highly successful in the long run," the authors write.

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Contact: Emily Parker
617-724-6425
JAMA and Archives Journals
15-Mar-2005

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