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Survey reveals that hospital leaders are concerned about the impact of mandatory error-reporting systems

A recent survey of hospital leaders found that nearly 70 percent believed that a non-confidential, mandatory error-reporting system would discourage staff from reporting patient safety incidents to their hospital's own internal reporting system. Almost 80 percent of those surveyed thought such a system would encourage lawsuits.

The survey involved chief executive and chief operating officers from randomly selected hospitals in two States with mandatory reporting and public disclosure, two States with mandatory reporting without public disclosure, and two States without mandatory systems in 2002-2003. Responses were received from 203 of 320 hospitals contacted. The study was supported by the Agency for Healthcare Research and Quality (HS11928) and conducted by Joel S. Weissman, Ph.D., of Massachusetts General Hospital and his colleagues.

More than 80 percent of the hospital leaders felt the names of both the hospital and involved staff members should be kept confidential. However, respondents from States with mandatory, non-confidential systems already in place were more willing to have hospital names released. Over 90 percent of survey respondents said their hospital would report serious injuries to their State hospital licensing agencies but far fewer would report moderate or minor injuries. However, the hospital leaders surveyed generally did favor disclosing patient safety incidents to involved patients.

According to the authors, the findings will help determine how better to work with hospitals to encourage reporting of adverse events as recommended by the 1999 Institute of Medicine report, To Err is Human, and to foster honest, open discussion between hospital representatives and patients when an unanticipated outcome occurs during hospital care.

See "Error reporting and disclosure systems: Views from hospital leaders," by Dr. Weissman, Catherine L. Annas, J.D., Arnold M. Epstein, M.D., M.A., and others, in the March 16, 2005, Journal of the American Medical Association 293(11), pp. 1359-1366.

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