Investigating the relationships among error culture, error reporting, and performance: A panel study

Errors can have far-reaching consequences, especially in high-reliability contexts like healthcare. While it has been highlighted long ago, that organizations are able to learn from negative performance feedback that might have its root cause in human errors, the process how management becomes aware of errors has not yet been fully understood. Whereas research mostly assumes that employees share negative feedback with their superiors in a timely and accurate manner, upward flows of negative information are often delayed, sugarcoated, or even suppressed. Guided by the behavioral theory of the firm, we stress the importance of internal performance feedback and introduce organization-level error reporting as a key mechanism that triggers problemistic search activities of management. We incorporate temporal dynamics in current theorizing and provide new insights into the interplay of organizational error culture, error reporting, and organizational performance. Based on a large, longitudinal data set of public hospitals in England, our study successfully demonstrates that, within organizations, an increase in positive error culture increases organizations’ error reporting rate which in turn reduces the number of fatal patient safety incidents over time. Moreover, the investigation of lagged relationships offers a more nuanced understanding of how this within-organizational mediation process unfolds over time.