Examining influences on speaking up among critical care healthcare providers in the United Arab Emirates.

OBJECTIVE: Assess perceived barriers to speaking up and to provide recommendations for reducing barriers to reporting adverse events and near misses. DESIGN, SETTING, PARTICIPANTS, INTERVENTION: A six-item survey was administered to critical care providers in 19 Intensive Care Units in Abu Dhabi as part of an organizational safety and quality improvement effort. MAIN OUTCOME MEASURES: Questions elicited perspectives about influences on reporting, perceived barriers and recommendations for conveying patient safety as an organizational priority. Qualitative thematic analyses were conducted for open-ended questions. RESULTS: A total of 1171 participants were invited to complete the survey and 639 responded (response rate = 54.6%). Compared to other stakeholders (e.g. the media, public), a larger proportion of respondents 'agreed/strongly agreed' that corporate health system leadership and the health regulatory authority encouraged and supported error reporting (83%; 75%), and had the most influence on their decisions to report (81%; 74%). 29.5% of respondents cited fear of repercussion as a barrier, and 21.3% of respondents indicated no barriers to reporting. Barriers included perceptions of a culture of blame and issues with reporting procedures. Recommendations to establish patient safety as an organizational priority included creating supportive environments to discuss errors, hiring staff to advocate for patient safety, and implementing policies to standardize clinical practices and streamline reporting procedures. CONCLUSIONS: Influences on reporting perceived by providers in the UAE were similar to those in the US and other countries. These findings highlight the roles of corporate leadership and regulators in developing non-punitive environments where reporting is a valuable and safe activity.