Race Differences in Reported Harmful Patient Safety Events in Healthcare System High Reliability Organizations

J Patient Saf. 2020 Dec;16(4):e235-e239. doi: 10.1097/PTS.0000000000000563.


Objectives: The aim of the study was to determine whether race differences exist in voluntarily reported harmful patient safety events in a large 10 hospital healthcare system on a high reliability organization journey.

Methods: From July 1, 2015, to June 30, 2017, employees in a healthcare system based in Washington, District of Columbia, and Maryland voluntarily reported harmful patient safety events by type using a Patient Safety Event Management System. Inpatients, outpatients, and observation patients were identified as "black," "white," or "other" (N = 5038). Using retrospective analysis and χ goodness of fit, comparisons of race proportions were conducted to determine differences at the health system level, by hospital, by event type, and by severity.

Results: Significant race differences existed: (1) overall with higher proportions of whites and lower proportions of other in a Patient Safety Event Management System; (2) by type across races; (3) in six hospitals across races; and (4) by type and by hospital for blacks and whites. All differences were significant at P < 0.05.

Conclusions: Race differences in harmful events exist in voluntary reporting systems by type and by hospital setting. Healthcare organizations, particularly healthcare high reliability organizations, can use these findings to help identify areas of further study and investigation. Further study and investigation should include efforts to understand the root cause of the differences found in this study, including the role of reporting bias.

MeSH terms

  • Delivery of Health Care / standards*
  • Female
  • High Reliability Organizations*
  • Humans
  • Male
  • Patient Safety / standards*
  • Race Factors
  • Retrospective Studies