Errors in healthcare persist as a major patient safety concern and impose considerable financial strain, contributing to mortality, extended hospitalizations, and psychological harm to both patients’ families and the individuals involved in the error. While fostering a culture that encourages speaking up and reporting errors can help minimize their occurrence, the process remains highly complex and influenced by multiple interacting factors. This systematic review aims to identify individual-level attributes that either encourage or discourage speaking-up behaviors in the context of adverse events. Additionally, it examines the relationship between organizational strategies designed to enhance error reporting and individual characteristics, particularly perceptions of psychological safety. A systematic review of peer-reviewed healthcare literature focusing on individual attributes associated with error-reporting behaviors was undertaken. The search process identified 1233 studies published between 2015 and 2021. Among these, 81 full-text articles were screened for eligibility, and data were ultimately extracted from 28 studies that met quality standards, as assessed using the Joanna Briggs Institute Critical Appraisal Tools©. The analysis revealed that key individual-level factors influencing the decision to report or speak up about errors include self-assurance and favorable perceptions of oneself, the organization, and its leadership. Elements such as education, professional experience, and knowledge were identified as underlying components that strengthen confidence. In contrast, the most prominent barriers were: 1) self-protective tendencies driven by fear, and 2) unfavorable perceptions of oneself, the organization, and leadership. The findings suggest that perceptions of psychological safety are shaped not only by the environment but also by deeply embedded personal beliefs and values. This underscores the importance of addressing cultural and diversity-related factors in healthcare error reporting and highlights the need for tailored interventions that alleviate fear and encourage reporting behaviors.
