Risk Managers, Physicians, and Disclosure of Harmful Medical Errors

Loren, David J.; Garbutt, Jane; Dunagan, W. Claiborne; Bommarito, Kerry M.; Ebers, Alison G.; Levinson, Wendy; Waterman, Amy D.; Fraser, Victoria J.; Summy, Elizabeth A.; Gallagher, Thomas H.

doi:10.1016/s1553-7250(10)36018-1

Cited by 33 publications

(23 citation statements)

References 29 publications

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“…However, there were differences in the intention to conduct DPSI according to the type of medical error, similarly to what was observed with regard to actual frequency and intentions in hypothetical cases. In particular, most medical professionals still thought that DPSI was unnecessary in the case of a near miss [17,22,28-32]. For example, Evans et al [30] reported that 71.6% of radiation oncologists and trainees thought that near misses should not be disclosed, although 94.8% of them thought that serious medical errors should be disclosed.…”

Section: Resultsmentioning

confidence: 99%

Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review

Ock

Lim

et al. 2017

J Prev Med Public Health

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ObjectivesWe performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI).MethodsWe used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them.ResultsThere was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI.ConclusionsThe reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required.

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Section: Resultsmentioning

confidence: 99%

Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review

Ock

Lim

et al. 2017

J Prev Med Public Health

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“…Woolf et al 2 had already noted that caregivers do not necessarily accept that they make avoidable mistakes even when they recognised that caregivers do make mistakes. 36,37 This sort of attitude and behaviour, on the part of the caregivers, do not only militate against error detection and management, but also violates the ethical tenets of caregiver-patient relationship. Caregivers do not accept and communicate their errors to patients because of a number of reasons, some of which may be difficulties in facing angry patients and their families, 35,38 concern about the potential damage to their reputation 38,39 and due to fear of malpractice litigation.…”

Section: Discussionmentioning

confidence: 99%

Patients’ knowledge and perceived reactions to medical errors in a tertiary health facility in Nigeria

Ushie¹,

Salami²,

Jegede³

et al. 2013

Afr H. Sci.

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Background: Human errors in healthcare delivery pose serious threats to patients undergoing treatment. While clinical concern is growing in response, there is need to report social and behavioural context of the problem in Nigeria. Objective: To examine patients' knowledge and perceived reactions to medical errors. Methods: A cross-sectional survey was conducted using a semi-structured questionnaire was used to collect data from 269 in-patients and 10 In-Depth Interviews were conducted among health caregivers in the University of Calabar Teaching Hospital, Nigeria. Results: Majority (64.5%) of respondents reported annoyance and disappointment with medical errors. Severity of error (88.5%) and the perception of negligence mediated intention to litigate. Voluntary disclosure significantly reduced patients' intention to litigate caregivers (chi

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“…The measurement of disclosure with the vignettes was done as in the paper by Loren et al [19]. The doctors that selected partial disclosure were graded as non-disclosure.…”

Section: Methodsmentioning

confidence: 99%

“…Understanding the practise and the factors that influence doctors decision to disclose a medical error is important as it serves as a yardstick for policy makers to see the direction in the practice of autonomy in medicine in the country [18, 19]. It also helps in the empowerment of patients in healthcare and increase the knowledge and understanding of doctors which will subsequently help in the decision to disclosure [20, 21].…”

Section: Introductionmentioning

confidence: 99%

The intention to disclose medical errors among doctors in a referral hospital in North Malaysia

Rashid

2017

BMC Med Ethics

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BackgroundIn this study, medical errors are defined as unintentional patient harm caused by a doctor’s mistake. This topic, due to limited research, is poorly understood in Malaysia. The objective of this study was to determine the proportion of doctors intending to disclose medical errors, and their attitudes/perception pertaining to medical errors.MethodsThis cross-sectional study was conducted at a tertiary public hospital from July- December 2015 among 276 randomly selected doctors. Data was collected using a standardized and validated self-administered questionnaire intending to measure disclosure and attitudes/perceptions. The scale had four vignettes in total two medical and two surgical. Each vignette consisted of five questions and each question measured the disclosure. Disclosure was categorised as “No Disclosure”, “Partial Disclosure” or “Full Disclosure”. Data was keyed in and analysed using STATA v 13.0.ResultsOnly 10.1% (n = 28) intended to disclose medical errors. Most respondents felt that they possessed an attitude/perception of adequately disclosing errors to patients. There was a statistically significant difference (p < 0.001) when comparing the intention of disclosure with perceived disclosures. Most respondents were in common agreement that disclosing an error would make them less likely to get sued, that minor errors should be reported and that they experienced relief from disclosing errors.ConclusionMost doctors in this study would not disclose medical errors although they perceived that the errors were serious and felt responsible for it. Poor disclosure could be due the fear of litigations and improper mechanisms/procedures available for disclosure.

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Risk Managers, Physicians, and Disclosure of Harmful Medical Errors

Cited by 33 publications

References 29 publications

Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review

Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review

Patients’ knowledge and perceived reactions to medical errors in a tertiary health facility in Nigeria

The intention to disclose medical errors among doctors in a referral hospital in North Malaysia

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