Safety Alerts

Question: To meet the expectation that the sponsoring institution document the residents’ engagement in the safety alert process, we are contemplating requiring residents to submit safety alerts that are not anonymous. Is this a good idea?

There are GOOD reasons to require the residents to submit safety alerts that are NOT anonymous:

1)      It’s a requirement that the sponsoring institution document resident engagement in safety alerts*

2)      It provides accountability to the residents – if it’s a requirement, it will be tracked and part of their semi-annual evaluation documents

3)      It allows you assess competence at this importance skill – If you don’t know who is submitting, how can you judge competence or remediate if necessary?

There are also good reasons to allow residents to remain ANONYMOUS:

1)      If the safety alert involves the resident’s attending or co-resident, that might be a difficult position for the resident to be in

2)      If the resident feels that the environment is retaliatory, they won’t report safety alerts, even it’s made a requirement

Perhaps a discussion about the culture at your institution by the GMEC will determine which way you should go.

Some questions you could pose to your GMEC (with input from your Quality/Safety Liaison):

1)      Do the staff and physicians feel comfortable submitting safety alerts?

2)      What percentage of safety alerts come to us anonymously?

3)      How do we handle resident-involved safety alerts at this time?

4)      How do we close the loop on safety alerts so that people feel that it was a valuable use of their time to submit a safety alert?

*Sponsoring Institution Requirement: III.B. The Sponsoring Institution is responsible for oversight and documentation of resident/fellow engagement in the following: (Core) III.B.1. Patient Safety: The Sponsoring Institution must ensure that residents/fellows have: III.B.1.a) access to systems for reporting errors, adverse events, unsafe conditions, and near misses in a protected manner that is free from reprisal; and, (Core) III.B.1.b) opportunities to contribute to root cause analysis or other similar risk-reduction processes. (Core) (2018 Edition of the ACGME Sponsoring Institution Requirements)

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