In a cross-sectional survey of community-based healthcare professionals in Israel, nearly a quarter of respondents reported submitting at least one near-miss report over the prior year, with reporting significantly linked to targeted training, clinic work environment, and perceptual factors. The study, published in BMC Primary Care by researchers Avi Zigdon, Tova Tov El, and Rachel Nissanholtz-Gannot, explored how organizational, professional, and perceptual variables correspond with self-reported safety documentation before patient harm occurs.

Near-miss reporting can reveal system vulnerabilities before patient harm occurs, but evidence on reporting behaviour in primary and community care remains limited. To address this knowledge gap within outpatient environments, the investigation evaluated self-reported near-miss submissions among primary care and community healthcare staff operating across the Dan–Petah Tikva district of Clalit Health Services in Israel.

The research relied on an anonymous, web-based survey administered between January and March 2024 among physicians, nurses, and allied health professionals. A total of 205 questionnaires were returned, from which 186 complete responses were analyzed. The primary outcome was defined as self-reported submission of at least one near-miss report during the preceding year, while the survey did not assess whether respondents had actually encountered a near-miss event during that timeframe.

Researchers examined candidate correlates that spanned structural and perceptual dimensions, including work setting, holding a managerial position, receiving training on near-miss events, perceived reporting frequency, and the perceived importance of reporting. They also evaluated self-reported improvement resulting from an earlier report alongside the perception that a lack of organizational feedback explains why professionals fail to report. To assess these relationships, the authors applied a two-step hierarchical binary logistic regression entering structural variables first and perceptual variables second, internally validating the resulting model with 1,000 bootstrap resamples.

Across the analyzed sample, 45 out of 186 healthcare workers, or 24.2 percent, reported filing at least one near-miss report in the prior year. In the final multivariable regression model involving 180 participants, reporting was independently associated with working specifically in a primary care clinic (odds ratio 3.69, 95% confidence interval 1.42 to 9.55) and having received training on near-miss events (odds ratio 4.86, 95% confidence interval 1.69 to 13.94).

The multivariable analysis demonstrated that reporting was also linked to perceived importance of reporting (odds ratio 2.43, 95% confidence interval 1.16 to 5.11), self-reported improvement following a prior report (odds ratio 2.30, 95% confidence interval 1.42 to 3.73), and identifying a lack of feedback as a reason for non-reporting (odds ratio 2.21, 95% confidence interval 1.42 to 3.44). While holding a managerial position initially appeared relevant, its association attenuated after accounting for perceptual variables (odds ratio 2.20, 95% confidence interval 0.92 to 5.28). Internal validation of the final model demonstrated an optimism-corrected area under the receiver operating characteristic curve of 0.82 and a corrected calibration slope of 0.81.

The study authors emphasized that these exploratory cross-sectional associations must not be interpreted as causal predictors or measures of underreporting, particularly because the opportunity to encounter and report a near miss was unmeasured and two survey items referred to past reporting experiences. Because reporters rated both post-report improvements and post-report feedback deficits more highly, the researchers concluded that formal training programs and organizational responsiveness to incoming reports warrant future prospective evaluation in primary care.

Subject of Research: Factors associated with near-miss reporting among Israeli primary and community healthcare professionals

Article Title: Factors associated with near-miss reporting among healthcare professionals in Israeli primary and community care: a cross-sectional study

Article References: Zigdon, A., El, T. T., & Nissanholtz-Gannot, R. (2026). Factors associated with near-miss reporting among healthcare professionals in Israeli primary and community care: a cross-sectional study. BMC Primary Care. https://doi.org/10.1186/s12875-026-03584-z

Image Credits: AI Generated

DOI: 10.1186/s12875-026-03584-z

Keywords: near-miss reporting, primary care, community healthcare, patient safety, Clalit Health Services, Dan-Petah Tikva district, healthcare professionals, physicians, nurses, allied health professionals, cross-sectional study, hierarchical logistic regression, bootstrap validation, safety training, organizational feedback, system vulnerabilities, Israel healthcare