Residents and incident reporting: 4 years experience in an Italian academic hospital

Background Identifying events that may cause damage to patients and quantifying their severity and frequency are key steps to implement the necessary changes for risk reduction. Medical residents are part of the clinical team that provides care to patients, and for this reason they have to be involved in educational interventions and active incident reporting (IR). The aim of this investigation is to evaluate residents’ contribution to IR inside Udine Academic Hospital. Methods Since 2013 a specific training program for residents was launched and repeated every year for the newcomers. Between 2013 and 2016, anonymous voluntary IR were collected from the whole Hospital; reports were classified by topic, interested unit, reporter role, severity and frequency of the event. Data regarding residents number, specialties and duty period were obtained from University records. Full-time equivalents (FTEs) were calculated to quantify workforce of the residents over the years. Results In the 2013-2016 time span 234/672 residents (34.8%) have been involved in training activities. During this period residents reported 92 events. The Incident Reporting/Full-time Equivalent rate (IR/FTE) was 0 IR/FTE in 2013, 0.04 in 2014, 0.17 in 2015 and 0.10 in 2016, respectively. Self-reporting (when reporter’s unit and unit of occurrence of the event match) was 9.1% (2014), 6.0% (2015), 48.4% (2016) of total reports. Through the 4 years, Intensive Care residents had a 0.32 IR/FTE rate, surgery and medical residents had 0.05 IR/FTE, diagnostic services residents 0.01 IR/FTE. Conclusions Our study seems to show increasing trends of IR/FTE and self-reporting among residents after their inclusion in hospital educational interventions and risk management activities, suggesting a potential safety culture improvement. A higher tendency to report seems to be observable among residents in intensive care units, possibly because of major sensitivity due to care complexity. Key messages: Residents involvement in educational interventions and incident reporting system allows the hospital to expand safety culture among healthcare professionals. Collecting data of incident reports enables to assess the safety culture of the residents and their cultural improvement over the years.