Do EMS personnel identify, report, and disclose medical errors?

Prehosp Emerg Care 2006 Jan-Mar;10(1):21-7

Department of Emergency Medicine, UNC School of Medicine, Chapel Hill, NC 27599, USA.

Objective: To evaluate self-reports of prehospital providers' error frequency, disclosure, and reporting in their actual practice and in hypothetical scenarios.

Methods: The authors surveyed a convenience sample of prehospital providers attending a statewide emergency medical services conference using a two-part instrument. Part 1 evaluated respondent demographics and actual practice patterns. Part 2 used hypothetic scenarios to assess error identification, disclosure, and reporting patterns. Descriptive statistics and Fisher's exact tests were used to characterize demographics and practice patterns. For hypothetical scenarios, the authors calculated mean responses with 95% confidence intervals (CIs) to assess error identification, anticipated disclosure, and reporting patterns.

Results: The response rate was 88% (372/425). Analysis was limited to 283 (75% of 372) respondents who were emergency medical technicians and had complete data. In the previous year, 157 (55%) providers identified no errors in practice, 100 (35%) reported one or two errors, and 26 (9%) identified more than two errors. In approximately half of cases, identified errors were reported to the receiving provider, or supervisor. In hypothetical cases, severe errors were identified 93% (95% CI 92-94) of the time, but the ability of providers to identify mild errors significantly varied. In all scenarios, respondents were much more likely to report errors to the receiving hospital, their supervisor, and their medical director than to patients.

Conclusions: Prehospital providers demonstrate the capacity to identify, report, and, to a lesser extent, disclose errors in hypothetical scenarios but may not apply these skills uniformly in their own practices. Enhancing error management skills in prehospital clinical practice will require focused education and training.

Download full-text PDF

Source
http://dx.doi.org/10.1080/10903120500366011DOI Listing
June 2006
64 Reads

Publication Analysis

Top Keywords

disclosure reporting
12
identified errors
12
errors
8
practice patterns
8
error identification
8
actual practice
8
emergency medical
8
identify report
8
assess error
8
errors identified
8
prehospital providers
8
hypothetical scenarios
8
practice
5
rate 88%
4
capacity identify
4
88% 372/425
4
demonstrate capacity
4
providers demonstrate
4
372 respondents
4
respondents emergency
4

References

(Supplied by CrossRef)

Barach P et al.
BMJ 2000

Hobgood C et al.
Acad Emerg Med 2004

Fordyce J et al.
Ann Emerg Med. 2003

Stanhope N et al.
J Eval Clin Pract 1999

Cullen D J et al.
Jt Comm J Qual Improv. 1995

Croskerry P et al.
Can J Emerg Med. 2001

Hobgood C et al.
Acad Emerg Med. 2002

Gallagher T H et al.
JAMA 2003

Mazor K M et al.
Arch Intern Med 2004

Peabody J W et al.
JAMA 2000

Similar Publications