Parents' Perceptions of Medical Errors

Mazor, Kathleen M.; Goff, Sarah L.; Dodd, Katherine; Velten, Sarah J.; Walsh, Kathleen E.

doi:10.1097/pts.0b013e3181ddfcd0

Cited by 38 publications

(74 citation statements)

References 35 publications

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“…Are they right? Consistent with other research,5 the experiences of our participants do highlight the importance of tailoring institutional responses to individual patients' needs. That points away from using strict protocols—but does not mean guidelines should be abandoned.…”

Section: Discussionsupporting

confidence: 89%

“…Existing literature about injured patients' needs establishes some fundamentals: patients and families5 value efforts to prevent recurrences3 6 and disclosure communications that are honest, transparent, efficient and compassionate 3 7–9. Their accounts reveal that patient safety incidents often involve immense emotional, physical and financial impacts,10 which can be exacerbated by poor responses from providers 11 12…”

Section: Introductionmentioning

confidence: 99%

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Improving reconciliation following medical injury: a qualitative study of responses to patient safety incidents in New Zealand

Moore

2017

BMJ Qual Saf

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BackgroundDespite the investment in exploring patient-centred alternatives to medical malpractice in New Zealand (NZ), the UK and the USA, patients' experiences with these processes are not well understood. We sought to explore factors that facilitate and impede reconciliation following patient safety incidents and identify recommendations for strengthening institution-led alternatives to malpractice litigation.MethodsWe conducted semistructured interviews with 62 patients injured by healthcare in NZ, administrators of 12 public hospitals, 5 lawyers specialising in Accident Compensation Corporation (ACC) claims and 3 ACC staff. NZ was chosen as the research site because it has replaced medical malpractice litigation with a no-fault scheme. Thematic analysis was used to identify key themes from interview transcripts.ResultsInterview responses converged on five elements of the reconciliation process that were important: (1) ask, rather than assume, what patients and families need from the process and recognise that, for many patients, being heard is important and should occur early in the reconciliation process; (2) support timely, sincere, culturally appropriate and meaningful apologies, avoiding forced or tokenistic quasi-apologies; (3) choose words that promote reconciliation; (4) include the people who patients want involved in the reconciliation discussion, including practitioners involved in the harm event; and (5) engage the support of lawyers and patient relations staff as appropriate.DiscussionPolicymakers and healthcare institutions are keenly interested in non-litigation approaches to resolving malpractice incidents. Interviewing participants involved in patient safety incident reconciliation processes suggests that healthcare institutions should not view apology as a substitute for other remedial actions; use flexible guidelines that distil best-practice principles, ensuring that steps are not missed, while not prescribing a ‘one size fits all’ communication approach.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Improving reconciliation following medical injury: a qualitative study of responses to patient safety incidents in New Zealand

Moore

2017

BMJ Qual Saf

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“…Studies of patients’ actual experiences with disclosure of adverse events provide important insights that significantly extend the findings of these earlier studies, and also help to define what patients want after an event has occurred 17 ,18,21, 22 . First, patient interviews confirm that disclosure often does not occur.…”

Section: Introductionmentioning

confidence: 71%

Disclosure of Adverse Events in the United States and Canada: An Update, and a Proposed Framework for Improvement

Boyle

Wallace

et al. 2013

Journal of Public Health Research

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There is consensus that physicians, health professionals and health care organizations should discuss harm that results from health care delivery (adverse events), including the reasons for harm, with patients and their families. Thought leaders and policy makers in the USA and Canada support this goal. However, there are gaps in both countries between patients and physicians in their attitudes about how errors should be handled, and between disclosure policies and their implementation in practice. This paper reviews the state of disclosure policy and practice in the two countries, and the barriers to full disclosure. Important barriers include fear of consequences, attitudes about disclosure, lack of skill and role models, and lack of peer and institutional support. The paper also describes the problem of the second victim, a corollary of disclosure whereby health care workers are also traumatized by the same events that harm patients. The presence of multiple practical and personal barriers to disclosure suggests the need for a comprehensive solution directed at multiple levels of the health care system, including health departments, institutions, local managers, professional staff, patients and families, and including legal, health system and local institutional support. At the local level, implementation could be based on a translating-evidence-into-practice framework. Applying this framework would involve the formation of teams, training, measurement and identification of local barriers to achieving universal disclosure of adverse events.Significance for public healthIt is inevitable that some patients will be harmed rather than helped by health care. There is consensus that patients and their families must be told about these harmful events. However, there are gaps between patient and physician attitudes about how errors should be handled, and between disclosure policies and their implementation. There are important barriers that impede disclosure, including fear of consequences, attitudes about disclosure, lack of skill, and lack of institutional support. A related problem is that of the second victim, whereby health care workers are traumatized by the same harmful events. This can impair their performance and further compromise safety. The problem is unlikely to be solved by focusing solely on increasing disclosure. A comprehensive solution is needed, directed at multiple levels of the health care system, including health departments, institutions, local managers, professional staff, patients and families, and including legal, health system and local institutional support.

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“…17 A few adult studies have found that patients identify numerous verified errors and AEs not otherwise documented in the medical record. [18][19][20] Pediatric data on patient and family involvement in error and AE detection are limited [21][22][23][24] but similarly suggest that families often report verified errors and AEs that are not detected through other sources. 23 Given the family's central role in pediatrics, parent-reported errors may be a fruitful source of error and AE surveillance for hospitalized children and may provide lessons regarding the utility of family error reporting in other populations.…”

Section: Main Outcomes and Measures-medical Errors And Preventable Aesmentioning

confidence: 99%

Parent-Reported Errors and Adverse Events in Hospitalized Children

et al. 2016

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Parents' Perceptions of Medical Errors

Abstract: Perceived medical errors can impact both the patient and the family in many ways. We recommend that providers acknowledge the full impact of a perceived error and tailor their response to meet the specific needs of the patient and family.

Cited by 38 publications

References 35 publications

Improving reconciliation following medical injury: a qualitative study of responses to patient safety incidents in New Zealand

Improving reconciliation following medical injury: a qualitative study of responses to patient safety incidents in New Zealand

Disclosure of Adverse Events in the United States and Canada: An Update, and a Proposed Framework for Improvement

Parent-Reported Errors and Adverse Events in Hospitalized Children

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