Why Docs Stay Away from Error-Reporting Aids?

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Most often than not, when asked about why they fail to use online error-reporting tools to improve the safety and quality of patient care—most doctors would just say that “it’s too complicated” or “I just don’t have enough time.” However, researchers from Johns Hopkins have discovered that it is not that these docs are too busy nor they find the process to complicated, rather one common reason among radiation oncologists is that they fear being embarrassed and caught in trouble.

The investigators of the study emailed through anonymous surveys different physicians, nurses, radiation physicists and other radiation specialists at Johns Hopkins, North Shore-Long Island Health System in New York, Washington University in St. Louise, and the University of Miami.  They were asked anonymously about their reporting of errors and near-misses in carrying out radiotherapy. All four institutions mentioned above make use of an online error reporting tool through interdepartmental systems. About 274 respondents returned surveys completed with necessary data.

After analyzing the survey, only few nurses and doctors reported to have routinely accomplished these error reports. The opposite was true among physicists, dosimetrists and radiation therapists who were among the most diligent in reporting their errors and near-misses through the online system. Although almost all of them agree that reporting these incidences is their responsibility, many of them reported that they avoid getting into trouble, any possible lawsuits or being embarrassed by colleagues. This was reported by most residents and physicians.

More than 90 percent of the individuals involved in the study shared that they have observed many near-misses and errors in the course of their clinical practice. Most of the reports made were classified as near misses, which in turn does not report any harm done to the patient.

“It is important to understand the specific reasons why fewer physicians participate in these reporting systems so that hospitals can work to close this gap. Reporting is not an end in itself. It helps identify potential hazards, and each member of the health care team brings a perspective that can help make patients safer,” according to Johns Hopkins radiation oncology resident Kendra Harris, M.D.

Harris said that the good news is that only few respondents reported that the system was too complicated or they were too busy to fulfill their responsibility to report. “Respondents recognized that error events should be reported and that they should claim responsibility for them. The barriers we identified are not insurmountable,” she noted.

Harris also pointed out that these online reporting system tools must be viewed as quality improvement tools rather than punitive measures which will impose sanctions and put the blame to an individual. “These systems should not be viewed as punitive; rather, they’re a critical way to improve therapy,” shared Harris. “You can’t manage what you can’t measure.”

“A national system that collects pooled data about near-misses and errors, which are thankfully rare, may help us identify common trends and implement safety interventions to improve care,” Harris concluded.

 

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