Danish Doctors Want New System
to Report Medical Errors

Up to one third of Danish doctors and nurses consider leaving the profession because they are concerned about committing errors and harming patients, according to a new survey by researchers from the DSI Danish Institute for Health Services Research. The as yet unpublished study recommends that the Danish medical profession create a new system of reporting medical error that is managed by health professionals.

The survey of 2000 doctors and nurses found that most considered a system in which they could report errors confidentially to their superiors could be useful for patient safety. The research was commissioned by the Danish Ministry of Health and the government is expected to respond to the recommendations in the coming months.

In Denmark, "one in ten hospitalised patients is victim of a damaging medical action", said lead author Niels Hermann, from the DSI Danish Institute for Health Services Research. "It is estimated that about half of these accidents could be prevented", he adds. According to the report, the number of medical errors in Denmark is similar to that found in other countries with similar health systems.

The authors recommend an unconditional, confidential reporting system, in which the identity of the professional who reports an error would not be disclosed by those who receive and administer the system. However, most of the surveyed doctors and nurses did not find such a system acceptable. "An anonymous system would not allow us to collect more information on the case, which could be necessary if we want to use this system to promote quality", says Doris Østergaard, from the Danish Institute for Medical Simulation at Herlev Hospital, University of Copenhagen.

The report compared medical and non-medical systems of reporting errors, especially within the aviation industry. The study suggests that the name of the medical department where the error took place should not be made public or be ranked by "quality of service". "There is no evidence that sanctions and publication of these data increases safety", says Hermann. The report suggests that reporting should be compulsory but flexible enough to allow reporting of other events that staff consider worth logging. There is also a clear preference for a system that allows the person reporting the error to speak to a someone in the same professional category.

One of the main issues facing any attempt to log errors is underreporting. To avoid this problem the report suggested that any new system would need support from leaders of medical departments and hospitals. The focus of any system should be to promote better quality health care and not disciplinary measures.
The Lancet, Vol 360, No. 9336, September 2002

CTM COMMENT: These data from Denmark corroborate the similar incidences of iatrogenic (doctor-induced) death we have examined in previous bulletins. Phillip Day's Health Wars covers this disturbing phenomenon in more detail, with regard to America, Britain, Australia and other nations, and also explains the simple measures that could be, but are not being taken to avoid it. www.credence.org