Improving Resident and Fellow Engagement in Patient Safety Through a Graduate Medical Education Incentive Program

Collaboration between graduate medical education (GME) and health systems is essential for the success of patient safety initiatives. One example is the development of an incentive program aligning trainee performance with health system quality and safety priorities.

We aimed to improve trainee safety event reporting and engagement in patient safety through a GME incentive program.

The incentive program was implemented to provide financial incentives to drive behavior and engage residents and fellows in safety efforts. Safety event reporting was measured beginning in the 2014-2015 academic year. A training module was introduced and the system reporting link was added to the institution's Resident Management System homepage. The number of reports by trainees was tracked over time, with a target of 2 reports per trainee per year.

Baseline data for the year prior to implementation of the incentive program showed less than 0.5% (74 of 16 498) of safety reports were submitted by trainees, in contrast with 1288 reports (7% of institutional reports) by trainees in 2014-2015 (P < .0001). A total of 516 trainees (57%), from 37 programs, received payment for the metric, based on a predefined program target of a mean of 2 reports per trainee. In 2015-2016 and 2016-2017 the submission rate was sustained, with 1234 and 1350 reports submitted by trainees, respectively.

An incentive program as part of a larger effort to address safety events is feasible and resulted in increased reporting by trainees.