EMS Personnel Are Most Apt to Report Errors in Emergency Tx.

[Ridryder 911]

EMS Personnel Are Most Apt to Report Errors in Emergency Care

By Bryan E. Bledsoe, DO, FACEP

May 2006, MERGINET—If you practice in the field of emergency medicine or emergency medical services long enough, you will make a mistake. It has happened to all of us and it will happen to you. In an interesting study, researchers compared emergency medicine physicians, emergency nurses and prehospital EMTs in their identification, disclosure and reporting of medical errors.

Providers were given 10 case vignettes that represented two types of errors (medication and cognitive) and three severity levels. Each provider was asked to answer the following questions about each case:

1. Is this an error?

2. Would you tell the patient?

3. Would you report this to a hospital committee?

One hundred three providers completed the study (40 physicians, 26 nurses and 35 EMTs). Physicians were more likely to classify an event as an error (78 percent) than nurses (71 percent) or EMTs (68 percent). Nurses were less likely to disclose an error to a patient (59 percent compared to physicians (71 percent). EMTs were the most likely to report an error (78 percent) compared to physicians (54 percent) or nurses (68 percent).

Overall, EMTs are honest and likely to report errors. There are various reasons why nurses and physicians are less likely to report. But, this affirms that prehospital providers are genuinely honest and will report most errors. This should be a reassuring study for EMS system administrators and medical directors.

Reference

Hobgood C. Weiner B. Tamayo-Sarver JH. “Medical Error Identification, Disclosure, and Reporting: Do Emergency Medicine Provider Groups Differ?” Academic Emergency Medicine 2006; 13:443-451.

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Is this really the point or are more of attack dogs upon each other and back stabbers ?... As seen on some post, some medics cannot wait to be able to report someone, before even discussing it with them, or are we just that honest and truly look out for the "good"..?

R/r 911

[AZCEP]

Most providers are so insecure with their own ability that they can't wait for someone else to make a mistake. If only so they can jump on it, and deflect attention from themselves for a while.

Get three different levels of providers together, and you can bet that they will report the others mistakes long before their own. We the unknowing, led by the unwilling, etc., etc.

[Dustdevil]

Were the scenarios all where the individual respondent was the one in error?

Or were the scenarios where somebody else made the error?

Or a mix of the two?

Makes a HUGE difference.

I think the bigger problem that is illustrated here everyday is that a great many providers are too stupid or uneducated to even know when they have made an error. :?

[RogueMedic]

Reporting errors is in my opinion an exercise in integrity. Should a person realize that mistakes were made, and caught them, documented and reproted thse errors, then we've certainly benefitted from it, hopefully not at the expense of someone's loss of life. For somone to admit that they screwed up shows that they are cognizant of thieir protocols, are competent in their skills, and recognize the need for change in certain things. Covering up mistakes sheds a greater, much brighter light on the subject and leaves more room to find greater problems that some may feel are better never to be spoken of aloud let alone in public.

The day that anyone of us "Chosen Ones" feel that we cannot learn anymore, or that we are infallible, it is time to get out of this business and seek life elsewhere. Perhaps Yak Herding or Typewriter Maintenance. But then again, that''s just my two cents.

[Scaramedic]

I believe an argument could be made it has nothing more to do with honesty than it has to do with the repercussions. An MD makes a mistake he is more liable than an RN, and an RN is more liable than an EMT. The higher the education, the higher the responsibility and therefore more liability. EMS personnel are at the bottom of the food chain in this situation, they have less to fear and less to lose. So when it comes to admitting mistakes EMT's might be more likely to report it because the repercussions will be less.

Peace,

Marty

:thumbleft:

[nsmedic393]

Reporting errors is in my opinion an exercise in integrity. Should a person realize that mistakes were made, and caught them, documented and reproted thse errors, then we've certainly benefitted from it, hopefully not at the expense of someone's loss of life. For somone to admit that they screwed up shows that they are cognizant of thieir protocols, are competent in their skills, and recognize the need for change in certain things. Covering up mistakes sheds a greater, much brighter light on the subject and leaves more room to find greater problems that some may feel are better never to be spoken of aloud let alone in public.

I agree completely. Good and bad medics alike make mistakes. Its the good ones that admit they made a mistake, learn from it and use that knowledge to benifit their patients in the future.

[Dustdevil]

Hmmm... I was thinking a little differently. Wheras if a doctor or nurse makes a mistake, it is usually no big deal. When a medic makes a mistake, it is usually in a critical situation where severe consequences are more likely. And since EMS management tends to not give a fark about their easily replaceable, dime a dozen employees, an EMT is much more likely to get fired for a simple mistake than a doctor or nurse too.

It is unfortunate that more EMS management doesn't think like Rogue. Most EMS managers only use your honesty as an excuse to can you. Of course, we use the term "management" very loosely in EMS too since most of them are clueless as to how to professionally manage human beings.

[RogueMedic]

Thanks Dust, but for those that don't know me, be advised, I look forward to every opportunity to leave my office and get on a truck and see patients.

[nsmedic393]

Perhaps if companies are so quick to can medics, you should form a union. Here the province is responsible for QA/QI and if you screw up bad enough, they pull your license.

[vs-eh?]

It has been told to us time after time that honesty is the best policy when it comes to medication/treatment errors. Failure to realize the error or especially failure to disclose it to the receiving hospital and your base hospital physician will only cause you more issues. Try and cover up the issue? Whelp, good luck is all I have to say...

Any level of provider at any level of competency or "intelligence" will eventually make a mistake somewhere down the line. Realize it, report it, and confess to it (we have a confession line). From what I have been told, as long as you are honest and don't risk patient harm (i.e. by NOT telling the ER where you brought the patient) you may only need a phone talking too/quick remedial teaching. Cover it up? Again, good luck...