A Patient Reported Approach to Identify Medical Errors and Improve Patient Safety in the Emergency Department

J Patient Saf. 2020 Sep;16(3):211-215. doi: 10.1097/PTS.0000000000000287.


Objective: Medical errors in the emergency department (ED) occur frequently. Yet, common adverse event detection methods, such as voluntary reporting, miss 90% of adverse events. Our objective was to demonstrate the use of patient-reported data in the ED to assess patient safety, including medical errors.

Methods: Analysis of patient-reported survey data collected over a 1-year period in a large, academic emergency department. All patients who provided a valid e-mail or cell phone number received a brief electronic survey within 24 hours of their ED encounter by e-mail or text message with Web link. Patients were asked about ED safety-related processes.

Results: From Aug 2012 to July 2013, we sent 52,693 surveys and received 7103 responses (e-mail response rate 25.8%), including 2836 free-text comments (44% of respondents). Approximately 242 (8.5%) of 2836 comments were classified as potential safety issues, including 12 adverse events, 40 near-misses, 23 errors with minimal risk of harm, and 167 general safety issues (eg, gaps in care transitions). Of the 40 near misses, 35 (75.0%) of 40 were preventable. Of the 52 adverse events or near misses, 5 (9.6%) were also identified via an existing patient occurrence reporting system.

Conclusions: A patient-reported approach to assess ED-patient safety yields important, complementary, and potentially actionable safety information.

MeSH terms

  • Adult
  • Emergency Service, Hospital / standards*
  • Female
  • Humans
  • Male
  • Medical Errors / trends*
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Patient Safety / standards*
  • Young Adult