Near Miss Identification and Reporting in Perioperative Anesthesia Care

Near misses occur frequently in perioperative care but are inconsistently reported, limiting their contribution to system-level safety improvement. A cross-sectional survey was administered to anesthesia providers at a single academic center to assess near miss experience, reporting behavior, perceived barriers, and event classification accuracy using clinical vignettes. Forty-nine respondents (17.3% response rate) participated. Nearly all respondents (98.0%) reported exposure to a near miss, while 42.9% indicated that such events were reported. The most identified barriers included reporting process complexity (55.1%), uncertainty about reporting procedures (42.9%), and ambiguity in event classification (38.8%). Scenario-based assessment demonstrated substantial variability in distinguishing near miss from no-harm events, particularly in routine or borderline clinical scenarios. These findings define key areas for targeted intervention to improve near miss reporting.