Medical error identification, disclosure, and reporting: Do emergency medicine provider groups differ?

Cherri Hobgood, Bryan Weiner, Joshua H. Tamayo-Sarver

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Objectives: To determine if the three types of emergency medicine providers - physicians, nurses, and out-of-hospital providers (emergency medical technicians [EMTs]) - differ in their identification, disclosure, and reporting of medical error. Methods: A convenience sample of providers in an academic emergency department evaluated ten case vignettes that represented two error types (medication and cognitive) and three severity levels. For each vignette, providers were asked the following: 1) Is this an error? 2) Would you tell the patient? 3) Would you report this to a hospital committee? To assess differences in identification, disclosure, and reporting by provider type, error type, and error severity, the authors constructed three-way tables with the nonparametric Somers' D clustered on participant. To assess the contribution of disclosure instruction and environmental variables, fixed-effects regression stratified by provider type was used. Results: Of the 116 providers who were eligible, 103 (40 physicians, 26 nurses, and 35 EMTs) had complete data. Physicians were more likely to classify an event as an error (78%) than nurses (71%; p = 0.04) or EMTs (68%; p < 0.01). Nurses were less likely to disclose an error to the patient (59%) than physicians (71%; p = 0.04). Physicians were the least likely to report the error (54%) compared with nurses (68%; p = 0.02) or EMTs (78%; p < 0.01). For all provider and error types, identification, disclosure, and reporting increased with increasing severity. Conclusions: Improving patient safety hinges on the ability of health care providers to accurately identify, disclose, and report medical errors. Interventions must account for differences in error identification, disclosure, and reporting by provider type.

Original languageEnglish (US)
Pages (from-to)443-451
Number of pages9
JournalAcademic Emergency Medicine
Volume13
Issue number4
DOIs
StatePublished - Apr 1 2006
Externally publishedYes

Keywords

  • Emergency department
  • Medical error
  • Patient safety
  • Reporting systems

ASJC Scopus subject areas

  • Emergency Medicine

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