expir-ro: a collaborative international project for experimenting voluntary incident reporting in the public healthcare sector in romania

background: patient safety within healthcare systems is a central aspect of health policy in most developed countries. from april 2007 to may 2009, the pilot project expir-ro tested a voluntary incident reporting system in a public hospital in bucharest romania, in collaboration with two italian hospitals (in genoa and milan). methods: data were collected anonymously through a form based on the australian incident monitoring system. after appropriate training in reporting adverse events (aes), staff in the participating departments voluntarily completed the form. the study lasted 12 months in the bucharest and genoa hospitals and 3 months in the milan hospital. frequency distributions of replies and ae rates per 1,000 hospitalization days per month were assessed. results: overall, 185 aes were reported (58 in bucharest, 75 in genoa and 52 in milan). the corresponding rates (per 1,000 hospitalization days per month) were 1 in bucharest, 3 in genoa and 15 in milan. most aes were related to diagnostic (28%) and surgical (14%) procedures and patient falls (12%) in bucharest; patient falls (32%), nursing care (20%) and diag­nostic procedures (19%) in genoa; and nursing care (25%), drug prescription/ administration (21%) and diagnostic procedures (17%) in milan . seventy-three per cent of respondents in bucharest informed the patient of the ae, versus 64% in genoa and 43% in milan. conversely, 75% of respondents in genoa entered aes in medical records versus 53% in bucharest and 36% in milan. conclusion: expir-ro experience suggests that incident reporting could be introduced on a larger scale in romania.