Objective: To investigate the current status of medical incident reporting (MIR) among healthcare workers (HCWs) at Children's Hospital 2 (CH2) and to characterise reporting barriers using the COM-B framework.
Methods: Explanatory sequential mixed-methods study at CH2 (January - April 2024). Quantitative: self-administered questionnaire with 424 HCWs using a 12-item COM-B-based barrier instrument. Qualitative: 31 purposive in-depth interviews.
Results: 50.7% of HCWs had participated in MIR. In multivariable Poisson regression, female gender (PR = 1.26), working experience ≥ 1 year, direct patient care (PR = 1.72), and prior incident history (PR = 2.06) were associated with higher MIR. 56.4% reported ≥ 1 barrier; fear of discipline was most prevalent (42.7%). In qualitative COM-B coding, motivational barriers accounted for the highest proportion of codes (42.5%), followed by opportunity (39.1%) and capability (18.4%).
Conclusions: Improving MIR requires behavioural and organisational culture change, not merely procedural reform. COM-B guided interventions should prioritise motivation, followed by opportunity and capability.