The Role of Incident-Reporting Systems in Improving Patient Safety in Japanese Hospitals: A Comparative Perspective

Serious attention has been given to safety in many high-risk domains in Japan and elsewhere. Healthcare has been relatively slow to respond to the development of safety science. However, in many countries attempts have been made since the 1990s to reform the regulation of risks to patients, and Japan is no exception. Nationally, the Japan Council for Quality Health Care (JQ) manages the web-based reporting system and collects data about serious adverse events and incidents on a voluntary basis. This chapter compares how hospitals in Japan and England use their respective reporting systems as a source of learning, and highlights the importance of sociocultural and institutional contexts when examining socio-technical settings in healthcare. While this study was modelled upon that previously carried out in England, the scope of this chapter is broader, and targeted at country-level comparison. Semi-structured interviews were conducted with patient safety managers in three different types of hospitals in Japan (Dec 2016–Jun 2018) and experts in four European countries (Jan–Dec 2017). Our findings from the various frameworks and the patient safety managers’ perceptions suggest that web-based reporting has become an important tool, but human-to-human interactions and national policy contexts remain critical for understanding incident reporting and patient safety.