From the Disputing Blog of Karl Bayer, Victoria VanBuren, and Holly Hayes.
A new study published in the March edition of the Joint Commission Journal on Quality and Patient Safety (the full article is available for purchase here) and reported on American Medical News (available here) found that physicians are less likely than risk managers to tell patients when a medical error occurs. Physicians, however, are more likely to use the word “error” in describing the event and are quicker to say, “I’m sorry” than risk managers.
The study reports that these differences in disclosure attitudes could lead to conflict between risk managers and physicians and diminish the effectiveness of disclosing an error. As disclosures increasingly involve collaboration between these two groups, organizations can plan for this potential conflict and develop policies and procedures to resolve disagreements. The study authors recommend, “Programs to train physicians and risk managers in disclosure should include basic conflict resolution skills to reduce the likelihood that such disagreements will impair the disclosure process. In addition, institutional disclosure policies should clearly articulate who in the organization has final authority over whether and how disclosures will take place.”
“Historically, the role of the risk manager has been perceived as really geared toward protecting the interests of the hospital, and part of that includes protecting the reputation and financial interests of the institution,” said David J. Loren, MD, lead author of the study. This could result in risk managers being less likely to use the words, “error” and to “apologize” to patients. Physicians, on the other hand, may be embarrassed that the event occurred and concerned about the potential of a malpractice suit and therefore less likely to want to disclose a medical error.
The Agency for Healthcare Research and Quality (AHRQ) also reported on the study here. Almost 3,000 risk managers nationwide at health care facilities were surveyed in 2004-05 as part of the study. Physician responses came from nearly 1,300 doctors in Missouri and Washington state who were surveyed in 2003-04.
Please send us any comments about this study or any experience you have had with cases about disclosing medical errors.
“We will have to repent in this generation not merely for the vitriolic words or actions of the bad people, but for the appalling silence of the good people. We...By Kenneth Cloke