International Journal of Health Care Quality Assurance

Purpose – The purpose of this paper is to explore the reasons why Greek doctors are reluctant to report adverse events.

Design/methodology/approach – The paper is an exploratory study using the adverse events questionnaire, administered to 209 doctors in 14 major Athens hospitals, comprising university as well as tertiary.

Findings – The questionnaire showed a high degree of internal consistency (Cronbach's alpha 0.84), which revealed a four-factor solution, explaining 67.4 per cent of the variance. Three dominant reasons for not reporting, with which almost or more than 50 per cent of doctors strongly or slightly agreed, were identified as no tradition for bringing up adverse events and a belief that bringing up adverse events will not lead to any improvement and workload.

Research limitations/implications – Factors that dissuade doctors from bringing up adverse events may be projected not only by cultural aspects such as professional, national and organisational cultures but also by healthcare structural issues such as safety systems, rules and procedures, and relevant acts and regulations. The study has several noteworthy limitations. First, doctors' response was poor, which might conceal sample bias problems. Second, the present study identified four factors but the fourth factor was not well defined.

Originality/value – The study provides an understanding why physicians fail to report adverse events so that systems can be introduced and cultures developed, which make this easier.