A Novel Approach to Establish and Enhance Event Reporting Systems Among Resident Physicians.

Abstract

Event reporting systems are an integral part of patient safety programs that continue to remain a challenge primarily due to systems-based barriers. Smartphone use in patient care continues to be an ever-growing facet of medicine and patient care. Combining the problem of event reporting challenges with the modern resource of mobile phones may be used to promote a culture of safety and increase event reporting in the emergency department (ED) and the hospital among residents. We introduced a new method of event reporting for emergency medicine (EM) residents in the ED using a mobile messaging application widely used throughout the hospital to facilitate physician communication to report events. Implementation of the intervention occurred in three phases. During the preintervention phase, we retrospectively reviewed EM resident rates of event reporting and administered a survey regarding their attitudes toward the traditional system of event reporting. We then introduced the mobile messaging application-based event reporting system and tracked the number of events recorded during the first 8 months of implementation. Following the intervention, we administered a postintervention survey to the EM residents inquiring about the same metrics that were used in the preintervention survey. Forty EM residents reported a total of 147 events during the 8 months of the intervention phase compared to 12 reports during the prior year as whole, resulting in a 12-fold increase. The postintervention scores ranged from 55 to 73 with a mean (±SD) of 65 (±9). EM resident satisfaction rates and comfort level with the new reporting system increased by 232 and 104%, respectively, and the likelihood of reporting an event increased by 127% (p<0.02). The time required by EM residents to submit a report also decreased significantly. The implementation of a mobile application to target systems barriers associated with event reporting significantly increased event reporting by EM residents, improved EM resident attitudes about event reporting, and reduced the time required to submit an event, ultimately promoting a culture of safety.