Do EMS Personnel Identify, Report, andDisclose Medical Errors?

Abstract

Objective. To evaluate self-reports of prehospital providers' error frequency, disclosure, andreporting in their actual practice andin hypothetical scenarios. Methods. The authors surveyed a convenience sample of prehospital providers attending a statewide emergency medical services conference using a two-part instrument. Part 1 evaluated respondent demographics andactual practice patterns. Part 2 used hypothetic scenarios to assess error identification, disclosure, andreporting patterns. Descriptive statistics andFisher's exact tests were used to characterize demographics andpractice patterns. For hypothetical scenarios, the authors calculated mean responses with 95% confidence intervals (CIs) to assess error identification, anticipated disclosure, andreporting patterns. Results. The response rate was 88% (372/425). Analysis was limited to 283 (75% of 372) respondents who were emergency medical technicians andhad complete data. In the previous year, 157 (55%) providers identified no errors in practice, 100 (35%) reported one or two errors, and26 (9%) identified more than two errors. In approximately half of cases, identified errors were reported to the receiving provider, or supervisor. In hypothetical cases, severe errors were identified 93% (95% CI 92–94) of the time, but the ability of providers to identify mild errors significantly varied. In all scenarios, respondents were much more likely to report errors to the receiving hospital, their supervisor, andtheir medical director than to patients. Conclusions. Prehospital providers demonstrate the capacity to identify, report, and, to a lesser extent, disclose errors in hypothetical scenarios but may not apply these skills uniformly in their own practices. Enhancing error management skills in prehospital clinical practice will require focused education andtraining.