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Related Experiment Videos

Getting doctors to report medical errors: project DISCLOSE.

Emmanuel S King1, Darilyn V Moyer, Michael J Couturie

  • 1Department of Internal Medicine, Temple University Hospital, Temple University School of Medicine, Philadelphia, USA.

Joint Commission Journal on Quality and Patient Safety
|August 4, 2006
PubMed
Summary

A simplified incident reporting tool (DISCLOSE) significantly increased the number and types of patient safety incidents reported by internal medicine physicians. Physicians also reported higher satisfaction with this improved reporting process.

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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.

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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.