Improved incident reporting following the implementation of a standardized emergency department peer review process.
OBJECTIVE
Incident reporting is an important component of health care quality improvement. The objective of this investigation was to evaluate the effectiveness of an emergency department (ED) peer review process in promoting incident reporting.


METHODS
An observational, interrupted time-series analysis of health care provider (HCP) incident reporting to the ED during a 30-month study period prior to and following the peer review process implementation and a survey-based assessment of physician perceptions of the peer review process' educational value and its effectiveness in identifying errors.


METHODS
Large, urban, academic ED.


METHODS
HCPs were invited to participate in a standardized, non-punitive, non-anonymous peer review process that involved analysis and structured discussion of incident reports submitted to ED physician leadership.


METHODS
Monthly frequency of incident reporting by HCPs and physician perceptions of the peer review process.


RESULTS
HCPs submitted 314 incident reports to the ED over the study period. Following the intervention, frequency of reporting by HCPs within the hospital increased over time. The frequencies of self-reporting, reporting by other ED practitioners and reporting by non-ED practitioners within the hospital increased compared with a control group of outside HCPs (P = 0.0019, P = 0.0025 and P < 0.0001). Physicians perceived the peer review process to be educational and highly effective in identifying errors.


CONCLUSIONS
The implementation of a non-punitive peer review process that provides timely feedback and is perceived as being valuable for error identification and education can lead to increased incident reporting by HCPs.
Department of Emergency Medicine (MAR) and Department of Quantitative Health Sciences (BAB), University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA.
Martin A
MA
Reznek
Department of Emergency Medicine (MAR) and Department of Quantitative Health Sciences (BAB), University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA.
Bruce A
BA
Barton
D000328:Adult; D003625:Data Collection / Q000592:standards; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006302:Health Services Research; D006801:Humans; D065186:Interrupted Time Series Analysis; D008297:Male; D008330:Management Audit / Q000592:standards*; D019300:Medical Errors / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care; D018024:Peer Review, Health Care; D058996:Quality Improvement; D012308:Risk Management / Q000379:methods*; D017751:Safety Management / Q000592:standards
emergency medicine; incident reporting; peer review; quality improvement