AHRQ Spearheads Effort to Add Patient Voice to Error Reporting

In addition to the technical expert panel, a big part of the project involves talking directly with patients and getting feedback from them about how to design a consumer reporting system. The project members have conducted two focus groups so far. Participants in these were either a patient or a family member who had experienced an adverse event (a near miss or actual event). Greenberg says the plan is to conduct eight more focus groups.

"We're learning a lot from the patient population," says Sheridan. "In the design of the ideal patient reporting system, AHRQ has requested that we go out to this patient population and learn directly from them, and it's so often that piece is missed. When it comes to patient safety they forget the patient and so we're going directly into the trenches to patients who have thought about reporting what has happened to their family and run into barriers."

A third group of people from whom feedback is being solicited is a group of key stakeholders. Project members are interviewing national experts who are knowledgeable about patient safety from a multitude of backgrounds—including clinicians, patient advocates, representatives from healthcare organizations, and experts in quality improvement and event reporting, says Greenberg.

Ultimately, the groups and individuals involved in this project hope the recommendations developed will allow the steps for creating a consumer reporting system to be taken.

"I think that a consumer reporting system will give us a much better idea of the incidence of medical errors," says Sheridan. "We know that the current reporting systems are tragically underutilized so I think that patients can, by reporting, accelerate change, drive change, and demand change."

For more about the AHRQ's contract to decide on design elements of a consumer reporting system, see the September issue of Briefings on Patient Safety.