Paper short abstract:

This paper compares how hospitals in Japan and England use their respective reporting systems as a source of learning, and highlights the importance of cultural and institutional contexts when examining sociotechnical settings in healthcare.

Paper long abstract:

Safety has been given serious attention in many high-risk domains in Japan and elsewhere. Healthcare has been relatively slow in responding to the development of safety science. However, attempts have been made to reform the regulation of risks to patients since the 1990s in many countries, and Japan is no exception. Nationally, the Japan Council for Quality Health Care manages the web-based reporting system and collects data about serious adverse events and incidents on a voluntary basis. This paper compares how hospitals in Japan and England use their respective reporting systems as a source of learning, and highlights the importance of cultural and institutional contexts when examining sociotechnical settings in healthcare. While this study was modelled upon that previously carried out in England, the scope of this paper is broader, and targeted at country-level comparison. Moreover, semi-structured interviews were conducted with patient-safety managers in three different types of hospitals in Japan and experts in four European countries. Our findings from the various frameworks and the patient safety managers' perceptions suggest that web-based reporting became an important tool but human-to-human interactions and national policy contexts remain critical for understanding incident reporting and patient safety.