D. Vicente1, A. Loehrer1, S. Fisher1, J. Skibber1, E. Grubbs1, T. Aloia1 1University Of Texas MD Anderson Cancer Center,Houston, TX, USA
Introduction: Patient Safety Event (PSE) reporting is an important element of quality improvement. While surgical trainees have frequent exposure to and involvement in PSEs, repeated studies have shown that they seldom report such events. Herein, we describe surgical fellow’s attitudes towards PSE reporting at a tertiary cancer center.
Methods: We reviewed the PSE reports for the entire institution to quantify the number of trainee reports per year compared to other PSE reporters. After Institutional Quality Improvement Assessment Board approval, a 10-question survey regarding their perceptions of PSE reporting was administered to fellows in Complex General Surgical Oncology, Breast Surgical Oncology, Endocrine Surgery, Pediatric Surgery, and an International Fellow.
Results: Less than 1% of PSE reports between June 2016 and May 2017 were submitted by trainees institution-wide. 20 of 25 fellows completed the 10-question survey. While 90% of fellows were aware of the PSE reporting system, only 25% had ever submitted a report. While most trainees stated that anonymity did not influence their decision to report (35%), fellows were more likely to report support staff (70%), and nursing personnel (60%), and less likely to report either peers (5%) or physicians senior to them (0%). Additional barriers to reporting included the time burden to submit a PSE report (85%) and a concern that the PSE would have a limited impact on the system (80%). 80% of fellows agreed that they would be more likely to report a PSE with either improved reporting efficiency or guaranteed feedback regarding the report and subsequent actions taken to improve the system.
Conclusion: Barriers to PSE reporting exist amongst surgical fellows, and may include a hierarchical reporting bias. The time burden required to file the PSE report and concern over lack of impact of individual reports contribute to a lack of enthusiasm regarding PSE reporting. More efficient submission processes and report feedback may improve trainee participation in PSE reporting.