Medical errors; causes, consequences, emotional response and resulting behavioral change

Abstract

Objective:To determine the causes of medical errors, the emotional and behavioral response of pediatric medicine residents to their medical errors and to determine their behavior change affecting their future training.Methods:One hundred thirty postgraduate residents were included in the study. Residents were asked to complete questionnaire about their errors and responses to their errors in three domains: emotional response, learning behavior and disclosure of the error. The names of the participants were kept confidential. Data was analyzed using SPSS version 20.Results:A total of 130 residents were included. Majority 128(98.5%) of these described some form of error. Serious errors that occurred were 24(19%), 63(48%) minor, 24(19%) near misses,2(2%) never encountered an error and 17(12%) did not mention type of error but mentioned causes and consequences. Only 73(57%) residents disclosed medical errors to their senior physician but disclosure to patient’s family was negligible 15(11%). Fatigue due to long duty hours 85(65%), inadequate experience 66(52%), inadequate supervision 58(48%) and complex case 58(45%) were common causes of medical errors. Negative emotions were common and were significantly associated with lack of knowledge (p=0.001), missing warning signs (p=<0.001), not seeking advice (p=0.003) and procedural complications (p=0.001). Medical errors had significant impact on resident’s behavior; 119(93%) residents became more careful, increased advice seeking from seniors 109(86%) and 109(86%) started paying more attention to details. Intrinsic causes of errors were significantly associated with increased information seeking behavior and vigilance (p=0.003) and (p=0.01) respectively.Conclusion:Medical errors committed by residents have inadequate disclosure to senior physicians and result in negative emotions but there was positive change in their behavior, which resulted in improvement in their future training and patient care.

Factors contributing to the patient safety culture in Saudi Arabia: a systematic review

“…3 Despite increasing efforts to implement patient safety initiatives worldwide, patient harm represents the 14th leading cause of mortality and morbidity across the world. 4 The WHO has highlighted that 42.7 million adverse care events are recorded annually worldwide 5 ; patient safety is therefore perceived as a serious healthcare issue. Medical errors or harmful incidents involving patients are reported as serious threats to patient safety, because they may affect patients' physical, psychological, emotional and social well-being.…”

“…Medical errors or harmful incidents involving patients are reported as serious threats to patient safety, because they may affect patients' physical, psychological, emotional and social well-being. 5 Positive and strong patient safety cultures have been found to significantly reduce the number of adverse events reported in a healthcare organisation. 6 Improving patient safety culture positively influences and increases the commitment to reporting incidents among healthcare professionals.…”

Medical Error Disclosure can Rescue Malpractice Litigation

“…In addition, 49% were due to miscommunication with patients followed by 33% negligence. Bari et al, [16] in their research about causes of medical errors, highlight stress and fatigue due to long duty hours as the main cause of malpractice (66%). They also stated causes such as the lack of experience in treating physicians/doctors (52%) followed by deficient knowledge (40%), failure to recognize warning signs It is a cycle: personal distress and decreased empathy are associated with an increased risk of future errors.…”

How to ensure effective use of media to communicate with healthcare professionals and general public

“…Once we published a manuscript in Pakistan Journal of Medical Sciences on “Medical Errors, causes, consequences, emotional response and resulting behavior change”. 2 The study concluded that 128 out of 130 residents described some form of error. Serious errors were 19%, minor errors 48%, near misses 19%.…”