• Jt Comm J Qual Patient Saf · Mar 2010

    Risk managers, physicians, and disclosure of harmful medical errors.

    • David J Loren, Jane Garbutt, W Claiborne Dunagan, Kerry M Bommarito, Alison G Ebers, Wendy Levinson, Amy D Waterman, Victoria J Fraser, Elizabeth A Summy, and Thomas H Gallagher.
    • Division of Pediatrics, University of Washington, Seattle, USA. dloren@uw.edu
    • Jt Comm J Qual Patient Saf. 2010 Mar 1;36(3):101-8.

    BackgroundPhysicians are encouraged to disclose medical errors to patients, which often requires close collaboration between physicians and risk managers.MethodsAn anonymous national survey of 2,988 healthcare facility-based risk managers was conducted between November 2004 and March 2005, and results were compared with those of a previous survey (conducted between July 2003 and March 2004) of 1,311 medical physicians in Washington and Missouri. Both surveys included an error-disclosure scenario for an obvious and a less obvious error with scripted response options.ResultsMore risk managers than physicians were aware that an error-reporting system was present at their hospital (81% versus 39%, p < .001) and believed that mechanisms to inform physicians about errors in their hospital were adequate (51% versus 17%, p < .001). More risk managers than physicians strongly agreed that serious errors should be disclosed to patients (70% versus 49%, p < .001). Across both error scenario, risk managers were more likely than physicians to definitely recommend that the error be disclosed (76% versus 50%, p < .001) and to provide full details about how the error would be prevented in the future (62% versus 51%, p < .001). However, physicians were more likely than risk managers to provide a full apology recognizing the harm caused by the error (39% versus 21%, p < .001).ConclusionsRisk managers have more favorable attitudes about disclosing errors to patients compared with physicians but are less supportive of providing a full apology. These differences may create conflicts between risk managers and physicians regarding disclosure. Health care institutions should promote greater collaboration between these two key participants in disclosure conversations.

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