Integrating incident data from five reporting systems to assess patient safety: making sense of the elephant.
This provocative study compared safety data from five separate sources to derive a comprehensive picture of institutional safety. The investigators compared safety issues identified through traditional event reporting, patient complaints, executive walk rounds, malpractice claims, and risk management databases, and found that while each method identified important safety problems, there was little overlap in the types of events identified with each reporting mechanism. For example, diagnostic errors were frequently cited in malpractice cases, but executive walk rounds highlighted equipment and supply issues. Prior research confirms the need to use multiple data sources to realistically analyze safety at the institutional level. An accompanying commentary discusses the strengths and limitations of a broad range of safety monitoring methods, including those used in this study.