Hospital risk managers more likely than physicians to recommend error disclosure, but less likely to apologize
Hospital physicians and risk managers have different attitudes towards disclosing medical errors, which could lead to conflict between these key players in communicating errors to patients and their families. More risk managers than physicians strongly agreed that serious errors should be disclosed to patients (70 percent vs. 49 percent). Presented with two error scenarios, the risk managers were more likely than physicians to definitely recommend that the error be disclosed (76 percent vs. 51 percent) and to provide details on how the error would be prevented in the future (62 percent vs. 51 percent). Physicians were more likely than the risk managers to provide the patient with a full apology recognizing the harm caused by the error (39 percent vs. 21 percent).
The researchers conducted an anonymous national Web survey of hospital risk managers who were members of the American Society for Healthcare Risk Management between November 2004 and May 2005, producing 1,673 responses from 2,988 members who were involved in error disclosure (56 percent response rate). The survey results were compared with those from an earlier survey (July 2003 through March 2004) of 1,311 physicians in the States of Washington and Missouri (63 percent response rate). In addition to general questions, participants from both groups randomly received one of two medical cases that differed in the patient's awareness of the error. This factor is known to influence physician disclosure of errors.
Because of the potential differences in approach to communicating errors, health care institutions should promote greater collaboration between risk managers and physicians in disclosing errors to patients and their families. Otherwise, the differences in approaches to disclosure could lead to conflicts that could impair the disclosure of errors, the researchers note. Their study was funded in part by the Agency for Healthcare Research and Quality (HS11890 and HS14020).
More details are in "Risk managers, physicians, and the disclosure of harmful medical errors," by David J. Loren, M.D., Jane Garbutt, M.B., Ch.B., W. Claiborne Dunagan, M.D., and others in the March 2010 Joint Commission Journal on Quality and Patient Safety 36(3), pp. 101-108.
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