How MERP deals with anonymous reports
USP stresses confidentiality over anonymity
The United States Pharmacopeial Conven tion's (USP) Medication Errors Reporting Program (MERP) (a part of the Institute for Safe Medication Practices [ISMP] in Warminster, PA) allows anonymous reporting to its database, as does the Food and Drug Administration's (FDA) MedWatch program. According to operatives, this does encourage reporting. Their databases wouldn't have nearly as much valuable information were it not for anonymity on the part of reporters, they say. But anonymity significantly affects their ability to analyze incidents and determine common causes.
"We offer the option of anonymity," says Susan Proulx, PharmD, vice president of operations at ISMP. "However, we prefer that reports not be anonymous so if we have questions for follow-up, we can get back to the reporter." On the bottom of MERP's reporting form, the person reporting an event has the option of checking off boxes indicating where the information can be sent - to the FDA, to the pharmaceutical company involved, to the ISMP, or no further.
"We stress confidentiality more than anony mity," Proulx says. "When we send the reports on to the USP, we keep that information absolutely confidential if that's the reporter's wish." The reporter may be afraid of personal punitive repercussions, she says. "The outcome of a JCAHO event is very different from ours," says Proulx. "All we do is educate and pass information along so events don't recur at other hospitals. JCAHO can cause a loss of funding and other serious repercussions for hospitals."
The USP has an Internet program that encourages anonymous reporting. "The downside of anonymity is that we cannot talk to the reporter," says Michael Cohen, president of ISMP. "We have to rely upon them to be as thorough as we'd want them to be, and they most often are not." He says, however, that confidentiality is the cornerstone of his organization. "We haven't ever revealed the source of an error report unless we've been given specific permission to do so. Nor have we ever had our records subpoenaed. There are some differences between JCAHO and ISMP that make it safer for us to handle reports the way we do. ISMP has the right to protect its sources. If our records were subpoenaed even once, it would be a tragedy because the program would end, and this program has made tremendous improvements. There have been thousands of changes in labeling and practice as the result of practitioners feeling that they can come forward safely with anecdotal reports of incidents. This is the only way I know of making that happen."
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