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Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ?
Cherri Hobgood1, Bryan Weiner, Joshua H Tamayo-Sarver
1Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA. hobgood@med.unc.edu
Summary
Physicians, nurses, and emergency medical technicians (EMTs) differ in identifying, disclosing, and reporting medical errors. Patient safety interventions must consider these provider-specific differences in error management.
Area of Science:
- Emergency Medicine
- Patient Safety
- Healthcare Quality
Background:
- Accurate identification, disclosure, and reporting of medical errors are crucial for improving patient safety.
- Understanding variations in these processes among different healthcare provider types is essential for targeted interventions.
Purpose of the Study:
- To compare how physicians, nurses, and out-of-hospital providers (emergency medical technicians [EMTs]) identify, disclose, and report medical errors.
- To analyze differences based on provider type, error type (medication vs. cognitive), and error severity.
Main Methods:
- A convenience sample of 103 emergency department providers (physicians, nurses, EMTs) evaluated ten case vignettes depicting medication or cognitive errors of varying severity.
- Providers indicated if an event was an error, if they would disclose it to the patient, and if they would report it to a hospital committee.
- Statistical analysis involved three-way tables with Somers' D and fixed-effects regression to assess differences and the impact of covariates.
Main Results:
- Physicians were more likely to identify errors than nurses or EMTs.
- Nurses were less likely to disclose errors to patients compared to physicians.
- Physicians were least likely to report errors, while EMTs were most likely to report them.
- Error identification, disclosure, and reporting increased with greater error severity across all provider types.
Conclusions:
- Significant differences exist in medical error identification, disclosure, and reporting among physicians, nurses, and EMTs.
- Healthcare interventions aimed at improving patient safety must be tailored to account for these provider-specific variations in error management practices.