Reporting and Disclosing Medical Errors

Garbutt, Jane; Brownstein, Dena; Klein, Eileen J.; Waterman, Amy D.; Krauss, Melissa J.; Marcuse, Edgar K.; Hazel, Erik; Dunagan, W. Claiborne; Fraser, Victoria J.; Gallagher, Thomas H.

doi:10.1001/archpedi.161.2.179

Cited by 121 publications

(64 citation statements)

References 49 publications

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“…Overall, the findings of this review align with earlier studies that demonstrate the need for a comprehensive, multi-level approach to achieve a culture of transparency. 16,17 In the subsequent section, this system is discussed in terms of intrapersonal, interpersonal, institutional, and societal-level barriers that together can undermine transparency and the sense of psychological safety that is necessary for effective disclosure and learning from error.…”

Section: Resultsmentioning

confidence: 99%

“…1 For one thing, minor errors are more frequent and numerous and thus provide more information to understand the nature of medical errors. Moreover, research has shown that less serious errors are more likely to be reported altogether, 16 seeing that they are less likely to invoke feelings of guilt and shame among physicians. Lastly, many states face a number of challenges including small numbers of error reports, and a lack of clinical expertise and other resources that are critical for identifying error trends.…”

Section: Medico-legal Environmentmentioning

confidence: 99%

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Understanding the Barriers to Physician Error Reporting and Disclosure

Perez¹,

Knych²,

Weaver³

et al. 2014

Journal of Patient Safety

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Transparency initiatives will require vigorous, interdisciplinary efforts to address the systemic and pervasive nature of the problem. Several ethical and social-psychological barriers suggest that medical schools and hospitals should collaborate to establish continuity in education and ensure that knowledge acquired in early education is transferred into long-term learning. At the institutional level, practical and cultural barriers suggest the creation of supportive learning environments and private discussion forums where physicians can seek moral support in the aftermath of an error. To overcome resistance to culture transformation, incremental change should be considered, for example, replacing arcane transparency policies and complex reporting mechanisms with clear, user-friendly guidelines.

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Section: Resultsmentioning

confidence: 99%

Section: Medico-legal Environmentmentioning

confidence: 99%

Understanding the Barriers to Physician Error Reporting and Disclosure

Perez¹,

Knych²,

Weaver³

et al. 2014

Journal of Patient Safety

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show abstract

“…To our knowledge, there are no published empirical works on medical error disclosure in Nigeria. Most respondents in a survey of 557 pediatricians and pediatric residents in Washington in the USA had been involved in errors of varying degrees and more than 80% of them endorsed the need to report errors to the hospital [19]. A similar but cross-country survey among physicians in Canada and the USA reported that 98% of them endorsed reporting serious errors to patients while 58% of them had reported at least a serious error to a patient [20].…”

Section: Discussionmentioning

confidence: 99%

Surgeon-Patient Information Disclosure Practices in Southwestern Nigeria

Ogundiran

Adebamowo²

2011

Med Princ Pract

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Objective: This study examined the practice of information disclosure to patients by surgeons in Nigeria. Subjects and Methods: A 55-item self-administered semi-structured questionnaire was sent to 150 surgeons in southwestern Nigeria in 2004–2005. The data obtained from the completed questionnaire were analyzed using descriptive statistics. Results: Of the 150 surgeons, 102 completed the questionnaire, giving a response rate of 68.0%. Of these 102, 85 (85.3%) were men, 44 (43.1%) were consultants and 55 (54.0%) were senior and junior surgical trainees. Most were from surgical subspecialties and obstetrics and gynecology. A documented policy statement about information disclosure was not available in most hospitals. A third, i.e. 35 (34.3%), of the surgeons did not routinely engage patients in discussions about disease diagnosis, management and prognosis. Most, i.e. 73 (71.6%), would rather disclose worsening disease progression to the patient’s spouse. Others would disclose such information to the patient’s children, family members or clergy. This was presumably to shield the patient from psychological distress. Only 22 (21.6%) of them routinely disclose operative findings to patients or their families. Thirty (29.4%) of them had been involved in disclosing medical errors to their patients in the past while 63 (61.8%) respondents did not know if surgical errors with potentially negative consequences should be disclosed. Conclusion: Most of the surgeons in southwestern Nigeria did not routinely provide detailed information to patients about their illness and possible outcome of illness even in the presence of worsening disease progression and prognosis. When surgical errors with potential negative consequences occurred, the majority did not know if such errors should be disclosed.

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“…young physicians, will benefit most from learning opportunities, where they can discuss medical errors with their peers and supervisors [13,14]. …”

Section: Introductionmentioning

confidence: 99%

Medical errors and uncertainty in primary healthcare: A comparative study of coping strategies among young and experienced GPs

Nevalainen

Kuikka

Pitkälä

2014

Scandinavian Journal of Primary Health Care

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Objective. To study coping differences between young and experienced GPs in primary care who experience medical errors and uncertainty. Design. Questionnaire-based survey (self-assessment) conducted in 2011. Setting. Finnish primary practice offices in Southern Finland. Subjects. Finnish GPs engaged in primary health care from two different respondent groups: young (working experience ≤ 5years, n = 85) and experienced (working experience > 5 years, n = 80). Main outcome measures. Outcome measures included experiences and attitudes expressed by the included participants towards medical errors and tolerance of uncertainty, their coping strategies, and factors that may influence (positively or negatively) sources of errors. Results. In total, 165/244 GPs responded (response rate: 68%). Young GPs expressed significantly more often fear of committing a medical error (70.2% vs. 48.1%, p = 0.004) and admitted more often than experienced GPs that they had committed a medical error during the past year (83.5% vs. 68.8%, p = 0.026). Young GPs were less prone to apologize to a patient for an error (44.7% vs. 65.0%, p = 0.009) and found, more often than their more experienced colleagues, on-site consultations and electronic databases useful for avoiding mistakes. Conclusion. Experienced GPs seem to better tolerate uncertainty and also seem to fear medical errors less than their young colleagues. Young and more experienced GPs use different coping strategies for dealing with medical errors. Implications. When GPs become more experienced, they seem to get better at coping with medical errors. Means to support these skills should be studied in future research.

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Reporting and Disclosing Medical Errors

Cited by 121 publications

References 49 publications

Understanding the Barriers to Physician Error Reporting and Disclosure

Understanding the Barriers to Physician Error Reporting and Disclosure

Surgeon-Patient Information Disclosure Practices in Southwestern Nigeria

Medical errors and uncertainty in primary healthcare: A comparative study of coping strategies among young and experienced GPs

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