Evaluation of an anonymous system to report medical errors in pediatric inpatients.
OBJECTIVE
To compare reports of medical errors in hospitalized children submitted using an electronic, anonymous reporting system with those submitted via traditional incident reports.


METHODS
During the 3-month study period in 2003, reports of medical errors from 2 units at a large children's hospital were made using an electronic, anonymous system. Three reviewers independently evaluated each report and determined whether the events described constituted a medical error. An identical procedure was used to categorize medical error data collected via incident reports from the 2 study units from 1999 to 2002.


RESULTS
A total of 146 reports were made using the anonymous system, 131 of which documented medical errors. The rate of reporting medical errors with the anonymous system was 2.41/100 patient-days. The rate of reporting medical errors via incident reports in 1999-2002 was 2.40/100 patient-days. However, 33.8% of all incident reports dealt with mislabeled laboratory specimens; after excluding these reports, the rate of medical errors documented via incident reports was 1.56/100 patient-days. The rate of reporting was significantly higher with the anonymous system (rate ratio 1.54, 95% confidence interval 1.26, 1.90). With the anonymous system, 25.2% of reported medical errors were near-misses compared with 12.6% of the errors reported with the incident report system (P = .001).


CONCLUSIONS
Implementation of the anonymous reporting system with training was associated with a statistically significant increase in the rate of reported medical errors. The reporting of near-miss events was significantly increased, suggesting this may be a useful format for gathering data on this type of medical error.
Taylor
James A
JA
Developmental Center for Evaluation and Research in Pediatric Patient Safety, Seattle, Washington, USA. uncjat@u.washington.edu
Brownstein
Dena
D
Klein
Eileen J
EJ
Strandjord
Thomas P
TP
D004282:Documentation / Q000592:standards; D006776:Hospitals, Pediatric / Q000592:standards*; D006801:Humans; D007297:Inpatients; D019300:Medical Errors / Q000145:classification / Q000517:prevention & control / Q000706:statistics & numerical data*; D008510:Medication Systems, Hospital / Q000592:standards; D012308:Risk Management / Q000379:methods*; D017749:Total Quality Management / Q000379:methods; D014861:Washington