Leveraging Computerized Sign-Out to Increase Error Reporting and Addressing Patient Safety in Graduate Medical Education

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Electronic reporting systems are important components of the patient-safety movement but have been problematic particularly in capturing information from physicians. In an attempt to increase error reporting in our community hospital residency program, we devised a convenient safety log integrated into the computerized resident-patient sign-out. Safety-log events are discussed in weekly safety reports with emphasis on developing a safety culture and preventing further events. We report our experience implementing the safety log. The program quadrupled our contribution to the hospital quality assurance system and has led to significant system innovations. Challenges have included sharing information and improving accountability without humiliating participants or alienating co-workers, as well as sustaining the project over time. Residents are uniquely placed to provide insight into hospital systems. An error-reporting system based in a resident sign-out can leverage this role into an important tool for safety education and care improvement.