Getting doctors to report medical errors: project DISCLOSE.
BACKGROUND
Despite the number of patient safety incidents that occur in hospitals, physicians currently may not have the ideal incident reporting tools for easy disclosure. A study was undertaken to assess the effectiveness of a simplified paper incident reporting process for internal medicine physicians on uncovering patient safety incidents.


METHODS
Thirty-nine internal medicine attending physicians were instructed to incorporate the use of a simplified paper incident reporting tool (DISCLOSE) into daily patient rounds during a three-month period. All physicians were surveyed at the conclusion of the three months.


RESULTS
Compared with physician reporting via the hospital's traditional incident reports from the same time period, a higher number (98 incidents versus 37; a 2.6-fold increase) of incidents were uncovered using the DISCLOSE reporting tool in a larger number of error categories (58 versus 14, a 4.1-fold increase). When reviewed and classified with a five-point harm scale, 41% of events were judged to have reached patients but not caused harm, 33% to have resulted in temporary harm, and 9% of reports, though not considered events, were to indicate a "risky situation." Surveyed physicians were more satisfied with the process of submitting incident reports using the new DISCLOSE tool.


CONCLUSIONS
A simplified incident reporting process at the point of care generated a larger number and breadth of physician disclosed error categories, and increased physician satisfaction with the process.
King
Emmanuel S
ES
Department of Internal Medicine, Temple University Hospital, Temple University School of Medicine, Philadelphia, USA.
Moyer
Darilyn V
DV
Couturie
Michael J
MJ
Gaughan
John P
JP
Shulkin
David J
DJ
D001291:Attitude of Health Personnel; D003625:Data Collection / Q000379:methods; D005240:Feasibility Studies; D005568:Forms and Records Control / Q000379:methods; D006801:Humans; D007388:Internal Medicine; D019300:Medical Errors / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital / Q000523:psychology*; D010549:Personal Satisfaction; D015143:Philadelphia; D012308:Risk Management / Q000379:methods*; D014342:Truth Disclosure