title: Does error and adverse event reporting by physicians and nurses differ?
abstract: BACKGROUND
  Some hospitals have instituted voluntary electronic error reporting systems (e-ERSs) to gather data on medical errors, adverse events, near misses, or environmental issues in a peer review-protected environment. An e-ERS allows for real-time review, oversight, and intervention and provides insight into hospital processes in need of modification to reduce the likelihood of adverse hospital events. In a descriptive study of a standardized, Web-based reporting system, the reporting practices of physicians and nurses were compared.
  
  
  METHODS
  Twenty-nine acute care hospitals and one long-term care organization implemented an e-ERS between August 2000 and December 2005. The reporting system consisted of a secure, Web-based portal available on all hospital computers. Events were classified by the level of impact on the patient using a standard classification scheme. All reports that occurred from August 2000 through January 2006 were analyzed in aggregate analyses. Hospitals and patients were de-identified to study investigators.
  
  
  RESULTS
  Some 266,224 events were reported over 7.3 million inpatient days--1 event per 27.5 days. Physicians were the reporters of 1.1% of total events, nurses 45.3%, and other hospital employees 53.6%. Physicians were more likely to be the reporter for events that caused permanent harm, near death, or death of a patient (p < .01). Nurses were more likely to be the reporter for events that caused no or temporary harm (p < .01).
  
  
  CONCLUSIONS
  Physicians reported a narrower spectrum of events than nurses; they were more likely to report as the impact of events on patients increased but less likely to report fatal events. Nurses' reporting remained stable across impact levels. Differences exist between whether nurses and physicians report events; physicians must be encouraged to increase their reporting of adverse events.
authors.affiliation: Tufts University School of Medicine, Boston, USA.
authors.forename: Ethan J
authors.initials: EJ
authors.lastname: Rowin
authors.forename: David
authors.initials: D
authors.lastname: Lucier
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Pauker
authors.forename: Sanjaya
authors.initials: S
authors.lastname: Kumar
authors.forename: Jack
authors.initials: J
authors.lastname: Chen
authors.forename: Deeb N
authors.initials: DN
authors.lastname: Salem
mesh_terms: D006788:Hospitals, Voluntary; D006801:Humans; D020407:Internet; D019300:Medical Errors / Q000517:prevention & control / Q000592:standards / Q000706:statistics & numerical data*; D008491:Medical Informatics Applications; D008505:Medical Staff, Hospital; D009741:Nursing Staff, Hospital; D012308:Risk Management / Q000706:statistics & numerical data*; D014481:United States