Improving resident and fellow engagement in patient safety through a graduate medical education incentive program.

Voluntary reporting of safety events is a widespread patient safety practice, but safety events are known to be underreported, especially by physicians. This uncontrolled intervention study aimed to increase error reporting by residents and fellows by providing a financial incentive of about $200 to report at least two safety events per year. More than half of eligible trainee physicians received the incentive, and the resultant increase in safety reports was sustained over 3 years. One related commentary suggests providing team-based incentives instead of the individual payments, and another commentary questions whether increased safety reporting translates to safer care and urges caution in incentivizing event reporting. A past PSNet perspective discussed the effect of financial incentives on patient safety.