title: Voluntary Medical Incident Reporting Tool to Improve Physician Reporting of Medical Errors in an Emergency Department.
abstract: BACKGROUND
  Medical errors are frequently under-reported, yet their appropriate analysis, coupled with remediation, is essential for continuous quality improvement. The emergency department (ED) is recognized as a complex and chaotic environment prone to errors. In this paper, we describe the design and implementation of a web-based ED-specific incident reporting system using an iterative process.
  
  
  METHODS
  A web-based, password-protected tool was developed by members of a quality assurance committee for ED providers to report incidents that they believe could impact patient safety.
  
  
  RESULTS
  The utilization of this system in one residency program with two academic sites resulted in an increase from 81 reported incidents in 2009, the first year of use, to 561 reported incidents in 2012. This is an increase in rate of reported events from 0.07% of all ED visits to 0.44% of all ED visits. In 2012, faculty reported 60% of all incidents, while residents and midlevel providers reported 24% and 16% respectively. The most commonly reported incidents were delays in care and management concerns.
  
  
  CONCLUSIONS
  Error reporting frequency can be dramatically improved by using a web-based, user-friendly, voluntary, and non-punitive reporting system.
authors.affiliation: University of Texas Health Science Center, Department of Emergency Medicine, Houston, Texas.
authors.forename: Nnaemeka G
authors.initials: NG
authors.lastname: Okafor
authors.affiliation: University of Texas Health Science Center, Department of Emergency Medicine, Houston, Texas.
authors.forename: Pratik B
authors.initials: PB
authors.lastname: Doshi
authors.affiliation: University of Texas Health Science Center, Department of Emergency Medicine, Houston, Texas.
authors.forename: Sara K
authors.initials: SK
authors.lastname: Miller
authors.affiliation: University of Texas Health Science Center, Department of Emergency Medicine, Houston, Texas.
authors.forename: James J
authors.initials: JJ
authors.lastname: McCarthy
authors.affiliation: University of Texas Health Science Center, Department of Emergency Medicine, Houston, Texas.
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Hoot
authors.affiliation: University of Texas Health Science Center, Department of Emergency Medicine, Houston, Texas.
authors.forename: Bryan F
authors.initials: BF
authors.lastname: Darger
authors.affiliation: University of Texas Health Science Center, Department of Emergency Medicine, Houston, Texas.
authors.forename: Roberto C
authors.initials: RC
authors.lastname: Benitez
authors.affiliation: University of Texas Health Science Center, Department of Emergency Medicine, Houston, Texas.
authors.forename: Yashwant G
authors.initials: YG
authors.lastname: Chathampally
mesh_terms: D004635:Emergency Medicine / Q000592:standards*; D004636:Emergency Service, Hospital / Q000592:standards*; D006801:Humans; D020407:Internet; D019300:Medical Errors / Q000517:prevention & control*; D061214:Patient Safety / Q000592:standards; D011364:Professional Practice / Q000592:standards; D011785:Quality Assurance, Health Care; D012308:Risk Management / Q000592:standards*; D017751:Safety Management / Q000379:methods; D014584:User-Computer Interface