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Sunday, September 20, 2020
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So, You’ve Made a Medical Error — What Should You Tell the Patient?

While it’s difficult to quantify exactly how often medical errors happen or what their impact is on patients, research estimates that they kill between 210,000 and 440,000 people every year.

Of course, many more mistakes happen in healthcare settings that don’t take lives, so if this happens to you, what’s the best way to proceed with your patient? New research takes a stab at answering this perennial question.

What Did the Study Find?

Published in BMJ Quality and Safety, the study indicates that openly communicating with patients not only reduces the negative psychological effect of the error, but it also makes them less likely to avoid medical care in the future.

RELATED: Inpatient vs. Outpatient: Which is Associated with More Preventable Medical Errors?

The study focused on 253 Massachusetts adults who’d either experienced a medical error themselves or through a family member. Of these, 41 percent said the error occurred in an inpatient setting and 27 percent said ambulatory care or a provider’s office.

How do medical errors affect patients?

Participants reported the following consequences of medical errors, even years later:

  • Physical effects, such as loss of function
  • Emotional impacts, such as anxiety, anger, depression and feelings of abandonment or betrayal by the provider
  • Healthcare avoidance
  • Erosion of trust in healthcare

How does open communication minimize medical errors?

Researchers defined open communication with six qualities, including acknowledging the error, discussing the error openly, and using easily understood terms to describe what happened. Encouraging the patient to ask questions about the error was providers’ most frequent response; acknowledging that an error took place was the least.

Participants who experienced some degree of open communication with their providers after the error saw less emotional harm.

RELATED: Patients Can Tell When Clinicians Believe a Treatment Won’t Work — And It Affects the Outcome

For subjects who said they received no open communication, up to 52 percent experienced persistent abandonment, anger, depression and sadness; up to 80 percent avoided healthcare afterward. For those who reported seeing five out of six open-communication techniques, less than 10 percent experienced the same emotions, and only 30 percent avoided healthcare.

While the researchers caution that open communication won’t eliminate all the negative impacts of medical errors, they do support facilities establishing programs that promote these types of interactions.

RELATED: These 3 Conditions Cause Three-Fourths of the Most Harmful Diagnostic Errors

They write: “Communication and resolution programs (CRPs), not yet widely implemented, could increase open communication through structured disclosure practices, reducing some of the negative impact of medical error on patients and families.”

What Should Clinicians Do?

Hesitance to take responsibility for an error is only natural, especially since it may open you up to a malpractice lawsuit. But keep in mind that existing research doesn’t bear out that disclosing an error to a patient increases the likelihood of litigation. And many states, such as New York, have self-reporting laws on the books.

At the very least, acknowledging patients’ concerns and explaining how you can address the situation together could prevent them from avoiding healthcare in the future. Not to mention, you might find the lesson sticks with you that much longer.

References:

Association of open communication and the emotional and behavioural impact of medical error on patients and families: state-wide cross-sectional survey, BMJ Quality & Safety.

Communicating With Patients About Medical Errors, JAMA Internal Medicine.

Medical errors: Honesty is the best policy, Harvard Health Blog.

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