Determinants of the intention to speak up about medical error in primary healthcare settings in Chile

Abstract

Medical error frequently occurs in ambulatory care, and healthcare professionals may encounter situations in which they need to speak up to ensure better practice. This study aims to investigate the factors that influenced the intention to speak up about medical errors among healthcare professionals in primary care settings. Data

were generated through a national cross-sectional survey of primary healthcare cen- tres in the Republic of Chile. A research instrument was designed using the con- structs of the theory of planned behaviour and was analysed using the structural

equation model technique. In total, 203 healthcare professionals were recruited be- tween March and May 2020. The model showed that the intention to speak up was

directly and positively influenced by attitudes towards speaking up and perceived control (standard deviation [SD] = 0.284 and 0.576, respectively). Subjective norms

indirectly and negatively influenced the intention to speak up through attitudes to- wards speaking up and perceived control (total effect SD = –0.303). The exploratory

construct of willingness to change self-behaviour positively influenced the attitude

towards behaviour. The intention to speak up strongly influenced the speaking up be- haviour (total effect SD = 0.631). The proposed model explained 40% of the variance

in behaviour. Based on this model, it was concluded that the intention to speak up strongly influenced the speaking up behaviour and predicted it by 40%. Factors that modify the intention to speak up are expected to influence the occurrence of this behaviour. This knowledge will inform strategies to enhance communication among healthcare professionals, improve speaking up behaviour and improve patient care.