A 2023 scoping review by The Joint Commission revealed that patients from minoritized communities are more likely to experience adverse safety events but less likely to have those events reported through voluntary reporting systems. This alarming disparity underscores the critical need to enhance diversity in healthcare incident reporting systems to ensure more inclusive healthcare for all patients, regardless of age, race, gender, sexual orientation, or socioeconomic status.
By actively integrating equity and inclusion into reporting systems, healthcare organizations can uncover blind spots, mitigate disparities, and ultimately improve patient safety.
Healthcare is deeply personal, shaped by patients’ cultural identities, socioeconomic circumstances, and lived experiences. However, many healthcare incident reporting systems remain rooted in standardized practices that don’t account for this diversity.
Research shows that healthcare workers from underrepresented groups are less likely to report safety events or workplace concerns due to fear of retaliation, language barriers, or mistrust in institutional systems. This underreporting creates data gaps that obscure the full picture of safety risks and harm within the care setting.
These same patterns of inequity extend to patients as well. For example, a 2022 ECRI report noted that patients from racial and ethnic minority groups are more likely to experience adverse events in hospitals, and that providers are significantly less likely to report harmful events for these patients compared to white patients. This racial bias can result in harm, missed opportunities for learning, and persistent inequities in positive healthcare outcomes.
Improving diversity in healthcare incident reporting means recognizing that who reports—and who feels safe enough to report—shapes the completeness and quality of our safety data. Equitable care starts with ensuring that all voices are equally represented in that data.
Diversity in incident reporting refers to systems and practices designed to capture the full range of safety events by accounting for social, cultural, and identity-based differences among both staff and patients.
These systems prioritize psychological safety, access to reporting in a person’s preferred language, and equity-driven design principles to ensure that all voices are heard. The foundations of this approach involve using a “systems-informed” lens, which emphasizes understanding how identity, power structures, and marginalization impact the way incidents are experienced, reported, and resolved. This perspective aligns closely with healthcare’s movement toward more empathetic care.
At its core, inclusion-oriented reporting is about redesigning systems so that they’re reflective of the communities they serve. That includes creating space for staff to report instances of discrimination or bias, encouraging patient voices in post-care feedback, and equipping leadership with tools to identify and address patterns in the data.
Truly inclusive healthcare requires more than just a new form template. It calls for a shift in organizational culture where psychological safety is a truly lived value.
When frontline staff feel safe and supported in reporting errors or observations without fear of punishment or dismissal, reporting rates rise—and with them, opportunities to improve. Healthcare leaders play a critical role in shaping this environment. From how they respond to reports of racial bias or inequitable treatment, to how they invest in staff training, leadership commitment sets the tone for inclusive healthcare safety practices.
This commitment must be visible and consistent. That means moving beyond statements and embedding equity into everyday practices, such as:
When inclusive values are reflected in safety messaging, training, and data collection processes, the reporting system becomes more accessible—and more effective.
To support more inclusive healthcare, organizations can take several actionable steps:
When thoughtfully implemented, these tools promote not only a more complete picture of safety—but also a stronger, more just organization.
Embedding diversity in healthcare incident reporting is foundational to any safety program that truly protects all patients and staff. By building systems that are accessible, culturally responsive, and equity-focused, organizations can begin to address the root causes of underreporting and create safer outcomes for all.
Diverse teams bring diverse perspectives. When those perspectives are reflected in the data that is collected and acted upon, the entire healthcare system becomes stronger. It is time to move beyond checkbox inclusion and toward truly inclusive healthcare—where incident reporting is not only accessible and encouraged, but equitable.