• Cherri Hobgood, Jipan Xie, Bryan Weiner, and James Hooker.
• Department of Emergency Medicine (CH), The University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA. hobgood@med.unc.edu
• Acad Emerg Med. 2004 Feb 1;11(2):196-9.

ObjectivesTo gather preliminary data on how the three major types of emergency medicine (EM) providers, physicians, nurses (RNs), and out-of-hospital personnel (EMTs), differ in error identification, disclosure, and reporting.MethodsA convenience sample of emergency department (ED) providers completed a brief survey designed to evaluate error frequency, disclosure, and reporting practices as well as error-based discussion and educational activities.ResultsOne hundred sixteen subjects participated: 41 EMTs (35%), 33 RNs (28%), and 42 physicians (36%). Forty-five percent of EMTs, 56% of RNs, and 21% of physicians identified no clinical errors during the preceding year. When errors were identified, physicians learned of them via dialogue with RNs (58%), patients (13%), pharmacy (35%), and attending physicians (35%). For known errors, all providers were equally unlikely to inform the team caring for the patient. Disclosure to patients was limited and varied by provider type (19% EMTs, 23% RNs, and 74% physicians). Disclosure education was rare, with ConclusionsThis study suggests that error identification, disclosure, and reporting challenge all members of the ED care delivery team. Provider-specific education and enhanced teamwork training will be required to further the transformation of the ED into a high-reliability organization.

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