Lag time in an incident reporting system at a university hospital in Japan.
BACKGROUND
Delays and underreporting limit the success of hospital incident reporting systems, but little is known about the causes or implications of delayed reporting.


METHODS
The authors examined 6880 incident reports filed by physicians and nurses for three years at a national university hospital in Japan and evaluated the lag time between each incident and the submission of a report.


RESULTS
Although physicians and nurses reported nearly equal numbers of events resulting in major injury (32 v 31), physicians reported far fewer minor incidents (430 v 6387) and far fewer incidents overall (462 v 6418). In univariate analyses, lag time was significantly longer for physicians than nurses (3.79 v 2.20 days; p<0.001). In multivariate analysis, physicians had adjusted reporting lag time 75% longer than nurses (p<0.001) and lag time for major injuries was 18% shorter than for minor injuries (p = 0.011). Adjusted lag time in 2002 and 2004 were 34% longer than in 2003 (p<0.001).


CONCLUSIONS
Physicians report fewer incidents than nurses and take longer to report them. Quantitative evaluation of lag time may facilitate improvements in incident reporting systems by distinguishing institutional obstacles to physician reporting from physicians' lesser willingness to report.
Hirose
Masahiro
M
Harvard School of Public Health, Department of Health Policy and Management, Boston, Massachusetts, USA. mhirose@kuhp.kyoto-u.ac.jp
Regenbogen
Scott E
SE
Lipsitz
Stuart
S
Imanaka
Yuichi
Y
Ishizaki
Tatsuro
T
Sekimoto
Miho
M
Oh
Eun-Hwan
EH
Gawande
Atul A
AA
D016907:Adverse Drug Reaction Reporting Systems; D000704:Analysis of Variance; D003625:Data Collection; D004282:Documentation / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D007564:Japan; D019300:Medical Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D011785:Quality Assurance, Health Care; D012308:Risk Management; D012449:Safety; D013997:Time Factors