A Patient Reported Approach to Identify Medical Errors and Improve Patient Safety in the Emergency Department

Area of Science:

• Healthcare Quality
• Patient Safety
• Emergency Medicine

Background:

• Medical errors are prevalent in emergency departments (EDs).
• Traditional adverse event detection methods, like voluntary reporting, are insufficient, missing up to 90% of events.
• There is a need for improved patient safety assessment in EDs.

Purpose of the Study:

• To demonstrate the utility of patient-reported data for assessing patient safety in the ED.
• To identify medical errors and other safety issues through patient feedback.

Main Methods:

• Analysis of patient-reported survey data from a large, academic ED over one year.
• Electronic surveys (email/text) sent within 24 hours of ED encounter.
• Patients queried on safety-related processes, with free-text comments analyzed.

Main Results:

• Over 7,000 responses received from 52,693 surveys (25.8% email response rate).
• Approximately 8.5% of free-text comments indicated potential safety issues, including adverse events, near-misses, and care transition gaps.
• Patient-reported data identified 5 adverse events/near-misses missed by existing reporting systems (9.6% overlap).

Conclusions:

• Patient-reported data offers a valuable, complementary approach to assessing ED patient safety.
• This method yields actionable safety information not captured by traditional systems.
• Incorporating patient feedback can enhance the identification and mitigation of medical errors.