Do EMS personnel identify, report, and disclose medical errors?
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.
Hobgood
Cherri
C
Department of Emergency Medicine, UNC School of Medicine, Chapel Hill, NC 27599, USA. hobgood@med.unc.edu
Bowen
Josie Barnes
JB
Brice
Jane H
JH
Overby
Barbara
B
Tamayo-Sarver
Joshua H
JH
D000293:Adolescent; D000328:Adult; D030881:Disclosure / Q000706:statistics & numerical data; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008508:Medication Errors / Q000706:statistics & numerical data; D009657:North Carolina; D017751:Safety Management / Q000706:statistics & numerical data