Hatoun Jonathan, Suen Winnie, Liu Constance, Shea Sandy, Patts Gregory, Weinberg Janice, Eng Jessica
Boston Medical Center, Boston, MA
Boston University School of Medicine, Boston, MA Virginia Commonwealth University School of Medicine, Richmond, VA.
Am J Med Qual. 2016 Jul;31(4):308-14. doi: 10.1177/1062860615574504. Epub 2015 Mar 9.
Reasons for resident underutilization of adverse event (AE) reporting systems are unclear, particularly given frequent resident exposure to AEs and near misses (NMs). Residents at an academic medical center were surveyed about AEs/NMs, barriers to reporting, patient safety climate, and educational interventions. A total of 350 of 527 eligible residents (66%) completed the survey; 77% of respondents reported involvement in an AE/NM, though only 43% had used the reporting system. Top barriers to reporting were not knowing what or how to report. Surgeons reported more than other residents (surgery, 61%; medical, 38%; hospital-based, 15%; P < .01), yet more often felt that systems were unlikely to change after reporting (surgery, 49%; medical, 28%; hospital-based. 18%; P < .01). Residents preferred discussions with supervisors (52%) and department-led conferences (46%) to increased reporting. Efforts to increase resident reporting should address common barriers to reporting as well as department-specific differences in resident knowledge, perceptions of system effectiveness, and educational preferences.
住院医师对不良事件（AE）报告系统利用不足的原因尚不清楚，尤其是考虑到住院医师经常接触不良事件和险些发生的不良事件（NM）。对一家学术医疗中心的住院医师进行了关于不良事件/险些发生的不良事件、报告障碍、患者安全氛围和教育干预措施的调查。527名符合条件的住院医师中共有350名（66%）完成了调查；77%的受访者报告参与了不良事件/险些发生的不良事件，尽管只有43%的人使用了报告系统。报告的主要障碍是不知道报告什么或如何报告。外科住院医师的报告率高于其他住院医师（外科，61%；内科，38%；医院科室，15%；P<.01），但他们更常认为报告后系统不太可能改变（外科，49%；内科，28%；医院科室，18%；P<.01）。与增加报告相比，住院医师更喜欢与上级进行讨论（52%）和参加科室组织的会议（46%）。提高住院医师报告率的努力应解决报告的常见障碍以及住院医师在知识、对系统有效性的认知和教育偏好方面的科室差异。
