Near-miss reporting is vital in hospitals because it helps identify potential hazards before they become serious safety events. By encouraging staff to report and analyze near misses, hospitals and health systems can reduce risk, strengthen safe practices, and build a culture where patient safety is continuously prioritized.
What Is a Near Miss?
A near miss is an event that does not result in patient harm but has the potential to do so. Some safety models estimate that near misses can occur up to 300 times before a similar issue escalates into an adverse event, making them critical opportunities for prevention.
Examples of near misses include:
- A large needle is found on the floor where a patient had been located during physical therapy
- Chemotherapy drugs are mislabeled, but a nurse identifies the error before administration and alerts the pharmacy
- A nurse mistakenly places a wristband on a mother instead of the baby
- A lapse in hand hygiene protocols creates the potential for a healthcare-associated infection, but the oversight is corrected before any patient contact occurs
- Miscommunication leads to a surgical procedure being scheduled for the wrong body part, but the error is caught before the operation begins
- Equipment malfunctions during a procedure, but the issue is quickly resolved before it affects the patient
While a near miss may seem minor at first glance, it can be a critical indicator of potential and unseen risk. By identifying and addressing near misses, healthcare professionals can proactively reduce hazards, strengthen safety practices, and help prevent future patient harm.
The Transformative Power of Near Miss Reporting
Recognizing and reporting near misses is essential to building a strong culture of safety in healthcare. Each near miss offers a valuable learning opportunity, helping organizations identify process gaps, strengthen safety protocols, and make meaningful changes that can prevent future harm.
Despite their significant value, near misses in healthcare remain widely underreported. A 2024 analysis from the Hospital Quality Institute found that, since the launch of CHPSOData in October 2022, near misses accounted for only 11% of all reported events. Even more alarming, 45% of facilities with reported events had never submitted a near-miss report at all.
These findings reinforce a persistent challenge in patient safety: many organizations are still missing critical opportunities to identify hazards before they result in harm.
This underreporting underscores the need for a structured near-miss program: a comprehensive initiative designed to encourage employees to recognize and report potential hazards before they escalate into actual harm. When supported by leadership and embedded into daily workflows, near-miss reporting can become a foundational part of a proactive safety culture.
One example of this approach in action is ADN PSO’s “Good Catch” campaign, which was launched across 45 hospitals in Arkansas to address near-miss underreporting. The campaign led to a 47% increase in near-miss reporting compared to baseline, averaging 246 additional near misses reported each month.
Notably, 63% of participating hospitals also experienced a decrease in overall harmful events, demonstrating how proactive reporting efforts can help organizations identify risk earlier and prevent future patient harm. The program’s success encouraged all participating hospitals to continue supporting the campaign the following year.
What is a Near Miss Campaign?
A near-miss campaign is a structured, incentive-based program that’s designed to encourage staff to identify and report potential safety risks before they result in harm. At its core, a successful campaign helps reinforce a culture of safety by making reporting simple, visible, and meaningful.
The strongest near-miss campaigns typically have three key elements:
- They are easy to use
- They are clearly communicated
- They are tied to meaningful follow-up action
First, the reporting process must be simple and accessible. Staff should be able to submit near misses quickly, regardless of their role, shift, or access to a workstation. Mobile-friendly reporting tools, QR codes, and other convenient entry points can help remove common barriers and make it easier for employees to report concerns in the moment.
This ease of access is essential. When reporting is quick and straightforward, employees across the organization are more likely to participate. Over time, this creates a more complete picture of potential risks and gives leaders the data they need to identify patterns, prioritize improvements, and prevent future safety events.
Communication is also critical. Before launching a near miss campaign, organizations should clearly explain the purpose of the initiative, what qualifies as a near miss, and how employees can report one. Staff also need to know that near miss reporting is not about blame or punishment. Using positive language, such as “good catch” or “great catch,” can help reinforce the idea that reporting a near miss is a valuable contribution to patient safety.
Finally, a near miss campaign must lead to action. Employees are more likely to stay engaged when they see that their reports result in real improvements. Establishing a clear process for review, follow-up, and corrective action helps ensure that near miss reports are not simply collected, but used to strengthen safety practices. Sharing updates on changes made as a result of staff reporting can also build trust and encourage continued participation.
Incentivizing Staff to Participate in Near Miss Reporting
A strong recognition program can play an important role in the success of a near miss or “good catch” campaign. When leaders make a point to celebrate staff who speak up, they send a clear message: identifying potential safety risks is valued, encouraged, and central to the organization’s culture of safety.
The value of incentives was evident in ADN PSO’s Good Catch campaign. Among participating hospitals, 68% reported that rewarding staff was essential not only to maintaining strong reporting rates, but also to the overall success of the initiative.
This reinforces the importance of creating an incentive program that is simple, meaningful, and sustainable. Recognition does not always need to be elaborate. Even small gestures can help motivate employees, increase participation, and keep near miss reporting top of mind over time.
Some examples of staff recognition and incentives for employees who report near misses include:
- Gift cards
- Tickets sporting events, concerts, or movies
- Coffee club membership
- A reserved parking spot
- Free lunch
- Paid time off
How to Get Executive Buy-In
Successful near miss reporting starts with visible support from leadership.
When the C-suite actively endorses the program, it signals to physicians, managers, and frontline staff that reporting near misses is a priority… not an optional activity. Executive support is also essential for securing the resources, funding, and operational alignment needed to turn reported events into meaningful improvement.
Some topics to discuss when asking to gain senior leadership support include:
- Scope and purpose of the near-miss program
- Benefits of staff participation
- Current baseline near-miss data
- Program goals and success measures
- Needed resources and funding
- Budget considerations and implementation plans
Educating Staff on Near-Miss Reporting
Staff and physicians are often the first to notice near misses, which makes education a critical part of any good catch reporting program. Employees need to understand what qualifies as a near miss, why reporting matters, and how to submit a report quickly and confidently.
Organizations can support education through resources such as PowerPoint presentations, handouts, e-learning modules, and department-specific training.
To keep the near-miss program visible, near-miss reporting can also be promoted through:
- Shift huddles
- Internal newsletters
- Leadership rounding
- Committee meetings
- Email communications
Sustaining Momentum
Once a near-miss reporting program is launched, organizations must continue reinforcing its value so reporting becomes part of the culture. Ongoing communication, recognition, and follow-up help maintain engagement and show staff that their reports lead to real action.
Ways to sustain momentum include:
- Recognizing employees who actively support the program as patient safety champions
- Providing timely and relevant feedback at all organizational levels
- Tracking monthly near-miss volumes and comparing them to previous years
- Sharing reporting trends and insights with managers
- Modifying action plans based on findings and feedback from staff
Together, these strategies help organizations move beyond simply collecting near-miss reports. They create a stronger culture of continuous learning, where employees are encouraged to identify risks early, leaders act on the information provided, and safety improvements become part of everyday operations.
Ready to Get Started?
Learn how Sentact can help your organization encourage near-miss reporting and improve patient safety with our Best in KLAS event reporting system. Click here to get started.
