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J Patient Saf. 2016 Nov 2. [Epub ahead of print]

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

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1
From the *Department of Emergency Medicine, University of North Carolina (UNC) School of Medicine; †UNC School of Public Health; ‡UNC Health Care System, Chapel Hill, NC; §Department of Emergency Medicine, The George Washington University, Washington, DC; and the ¶Duke Clinical Research Institute, Duke University, Durham, NC.

Abstract

OBJECTIVE:

Medical errors in the emergency department (ED) occur frequently. Yet, common adverse event detection methods, such as voluntary reporting, miss 90% of adverse events. Our objective was to demonstrate the use of patient-reported data in the ED to assess patient safety, including medical errors.

METHODS:

Analysis of patient-reported survey data collected over a 1-year period in a large, academic emergency department. All patients who provided a valid e-mail or cell phone number received a brief electronic survey within 24 hours of their ED encounter by e-mail or text message with Web link. Patients were asked about ED safety-related processes.

RESULTS:

From Aug 2012 to July 2013, we sent 52,693 surveys and received 7103 responses (e-mail response rate 25.8%), including 2836 free-text comments (44% of respondents). Approximately 242 (8.5%) of 2836 comments were classified as potential safety issues, including 12 adverse events, 40 near-misses, 23 errors with minimal risk of harm, and 167 general safety issues (eg, gaps in care transitions). Of the 40 near misses, 35 (75.0%) of 40 were preventable. Of the 52 adverse events or near misses, 5 (9.6%) were also identified via an existing patient occurrence reporting system.

CONCLUSIONS:

A patient-reported approach to assess ED-patient safety yields important, complementary, and potentially actionable safety information.

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