Quality & Patient Safety

Good Catch program at Texas organization encourages near-miss reporting

Patient Safety Monitor, May 1, 2010

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Staff members are often trained to report a potential medical error, or near-miss event. However, more often than not, these events go unreported. In 2003, The University of Texas (UT) System, made up of six health institutions, developed a system that allowed the anonymous reporting of close calls, near misses, and potential errors.

Despite the reports’ anonymity, only 175 were gathered during the first two and a half years of the program.

After seeing this result, Robert L. Massey, PhD, RN, NEA-BC, director of clinical nursing at UT’s M. D. Anderson Cancer Center, and a former colleague wanted to know why the program was not working and how they could encourage staff to report medical errors.

In 2005, Massey and his former colleague proposed and implemented a pilot test of the Good Catch program at M. D. Anderson. By putting a positive spin on the reports (increased reporting of near misses helps the hospital learn how to prevent future errors) and developing a competition to encourage reporting, M. D. Anderson received 2,744 reports of potential errors during the initial six months of the pilot program.

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Patient Safety Monitor.

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