Patient Safety Incentives for Residents: A Slippery Slope or Reinforcement of Desirable Behavior?
Accreditation Council for Graduate Medical Education
Journal of Graduate Medical Education
In a study of error reporting in the care of Medicare beneficiaries, the US Department of Health and Human Services Office of Inspector General found that only 14% of patient safety events were reported.1 A multicenter study found that 44.6% of residents were uncomfortable reporting diagnostic errors, possibly related to fear of repercussions and issues with the reporting system, among other factors.2 A key question at the intersection of graduate medical education and patient safety is how to encourage resident and fellow error reporting.
The intervention described in the article, “Improving Resident and Fellow Engagement in Patient Safety through a Graduate Medical Education Incentive Program,”3 in this issue of the Journal of Graduate Medical Education produced results: nearly 4000 patient safety events were reported, a significant increase over the data from the preintervention period. Among those 4000 reports could be 1 or more producing measures that have a significant impact on patient safety, potentially saving lives. The intervention—paying residents for reporting errors—is simple. From a health systems perspective, the costs incurred are a concern and need to be weighed against their formal or informal returns on investment (ROIs). The following are considerations for that analysis.
Rapala, Kathryn, "Patient Safety Incentives for Residents: A Slippery Slope or Reinforcement of Desirable Behavior?" (2018). College of Nursing Faculty Research and Publications. 735.