Getting doctors to report medical errors: project DISCLOSE

Area of Science:

• Medical error analysis
• Healthcare quality improvement
• Physician reporting systems

Background:

• Physician incident reporting tools are often inadequate for effective patient safety disclosure.
• A need exists for improved methods to capture patient safety incidents in hospitals.

Purpose of the Study:

• To evaluate the effectiveness of a simplified paper incident reporting tool (DISCLOSE) for internal medicine physicians.
• To assess the impact of DISCLOSE on uncovering patient safety incidents and physician satisfaction.

Main Methods:

• Thirty-nine internal medicine physicians used the DISCLOSE tool during daily patient rounds for three months.
• Physician satisfaction was assessed via a survey at the study's conclusion.
• Incident reports generated by DISCLOSE were compared to traditional hospital reporting methods.

Main Results:

• The DISCLOSE tool uncovered a 2.6-fold increase in patient safety incidents (98 vs. 37) and a 4.1-fold increase in error categories (58 vs. 14).
• 41% of reported events reached patients without harm, 33% caused temporary harm, and 9% indicated risky situations.
• Physicians reported greater satisfaction with the simplified DISCLOSE reporting process compared to traditional methods.

Conclusions:

• A simplified, point-of-care incident reporting process significantly enhances the quantity and diversity of disclosed physician errors.
• The DISCLOSE tool improved physician satisfaction with incident reporting, suggesting a more effective approach to patient safety monitoring.