APPENDIX

This Appendix describes an alternative model that serves as a robustness test for our primary

model that estimated the frequency of solutions offered (Table 2, Model 2). This model estimates the

likelihood that solutions are offered conditional on an incident report being filed.

Empirical Model

We are interested in exploring whether information campaigns and managerial engagement in

process improvement increase the likelihood of employees offering solutions as part of their incident

reports. We estimated the following model with the individual incident report as the unit of analysis:

Offering Solutionsi,j,t = F(InfoCampt , MgrEngj,t-1 , Harmi , Equipmenti , Typei , Montht , Yeart , Unitj)

where F() is the logit function. This model estimates the likelihood of an employee offering a solution

when reporting incident i in hospital unit j on date t as a function of (a) whether or not the incident

occurred during a hospital-wide information campaign (InfoCampt) and (b) the level of managerial

engagement in process improvement in the previous year in the hospital unit in which the incident

occurred (MgrEngjt-1). These independent variables are identical to those in the primary analysis.

Because this model is at the incident-report level, we can control for additional factors that can

influence the likelihood of employees offering solutions in their incident reports. We control for actual or

potential patient harm as a result of the incident (Harmi) by including dummy variables denoting (a)

liability risk due to a patient being involved in the incident, (b) whether the incident involved obstetrics,

and (c) whether the incident occurred in a patient or clinical area. We also include a series of dummies

indicating whether the incident caused no patient harm, temporary patient harm, permanent patient harm,

or patient death. We also include a dummy indicating whether equipment was involved (Equipmenti) and

a full series of dummies indicating whether the incident type (Typei) was related to blood or blood

products; identification, documentation, or consent; lab specimen or test; or a surgery or procedure. The

“Measures” section below provides more detail on these measures.

We also control for the month in which the incident occurred by including a full set of month

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