Disclosure of medical error: Facts and fallacies

Porto, Grena

doi:10.1002/jhrm.5600210411

Cited by 9 publications

(8 citation statements)

References 53 publications

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“…We also reviewed the reference lists of published reviews and commentaries on disclosure of medical errors. [6][7][8][9][10][11][12][13][14][15][16][17][18][19]…”

Section: Search Strategymentioning

confidence: 99%

“…Ethical and professional guidelines, [1][2][3] credentialing organizations, 4 patient safety organizations, 5 and experts on medical errors advocate disclosure of medical errors to patients and families, [6][7][8][9][10][11][12][13][14][15][16][17][18][19] but there is little empirical evidence to guide practitioners. We found empirical support for concluding that disclosure often does not occur, 22,28,30,32,36 that patients and the public favor disclosure, 23,24,29,32,34 and that physicians support disclosure, 23,28,32 but we found no empirical results to guide practitioners with respect to the practical questions of who, what, when, and how to disclose.…”

Section: Commentmentioning

confidence: 99%

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Communicating With Patients About Medical Errors

Mazor

Simon²,

Gurwitz³

2004

Arch Intern Med

189

120

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Empirical research on disclosure of medical errors to patients and families has been limited, and studies have focused primarily on the decision stage of disclosure. Fewer have considered the disclosure process, the consequences of disclosure, or the relationship between the two. Additional research is needed to understand how disclosure decisions are made, to provide guidance to physicians on the process, and to help all involved anticipate the consequences of disclosure.

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“…We also reviewed the reference lists of published reviews and commentaries on disclosure of medical errors. [6][7][8][9][10][11][12][13][14][15][16][17][18][19]…”

Section: Search Strategymentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Communicating With Patients About Medical Errors

Mazor

Simon²,

Gurwitz³

2004

Arch Intern Med

189

120

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“…14 A different, and increasingly prominent, twist on the malpractice issue is that clinicians' and hospitals' perceptions about litigation risk may be worse than the reality. 15 The experience of the VA Medical Center in Lexington, Kentucky, where a proactive disclosure policy has reportedly not resulted in higher liability payments at the institutional level, is widely cited. 16 There is also growing anecdotal evidence from some nongovernmental hospitals, such as the Dana Farber Cancer Institute in Boston, that their policies to disclose have not been accompanied by a big increase in lawsuits.…”

Section: N F O R M a T I O Nmentioning

confidence: 99%

Hospital Disclosure Practices: Results Of A National Survey

Lamb¹,

Studdert²,

Bohmer³

et al. 2003

Health Affairs

128

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New patient safety standards from JCAHO that require hospitals to disclose to patients all unexpected outcomes of care took effect 1 July 2001. In an early 2002 survey of risk managers at a nationally representative sample of hospitals, the vast majority reported that their hospital's practice was to disclose harm at least some of the time, although only one-third of hospitals actually had board-approved policies in place. More than half of respondents reported that they would always disclose a death or serious injury, but when presented with actual clinical scenarios, respondents were much less likely to disclose preventable harms than to disclose nonpreventable harms of comparable severity. Reluctance to disclose preventable harms was twice as likely to occur at hospitals having major concerns about the malpractice implications of disclosure.T e ll i n g pat i e n ts a b o u t u nan t i c i pat e d o u tc o m e s of care is an established ethical expectation for physicians and nurses. 1 However, decisions about the appropriateness, timing, and content of disclosure have traditionally remained a private matter, left to the preferences of individual clinicians and health care institutions. Advances in informed-consent law and patients' rights over the past thirty years appear to have had little demonstrable impact on providers' willingness to disclose information about errors and adverse outcomes. 2 Today providers face new constraints in the area of disclosure. The Institute of Medicine's (IOM's) 1999 report, To Err Is Human, prompted calls for greater transparency in health care. 3 In July 2001 the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) responded by introducing new patient safety standards, including a requirement that all unanticipated outcomes of care be disclosed. 4 Although the requirement itself does not specify the need to disclose poor

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“…3,[7][8][9][10] Physicians' concerns about damage to the physician-patient relationship and about legal risk are 2 major barriers to full disclosure. While experts have suggested that full disclosure is both ethically correct and likely to result in better outcomes for physicians and patients, [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] there has been limited empirical research into the specific factors that influence patients' responses. Recent findings suggest that patients are likely to respond favorably to full disclosure, with full disclosure associated with lower likelihood of changing physicians, higher satisfaction, greater trust, a more positive emotional response, and less support for sanctions against the physician.…”

mentioning

confidence: 99%