We need to talk: Provider conversations with peers and patients about a medical error

Purpose Although open communication with patients is the established best practice after a medical error, healthcare providers’ conversations with each other in these circumstances are less studied. We identified and compared what providers identified as the most important thing to say to their peer...

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Veröffentlicht in:Journal of patient safety and risk management 2019-08, Vol.24 (4), p.140-146
Hauptverfasser: Dhawale, Tejaswini, Zech, Jennifer, Greene, Sarah M, Roblin, Douglas W, Brigham, Karen Berg, Gallagher, Thomas H, Mazor, Kathleen M
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container_end_page 146
container_issue 4
container_start_page 140
container_title Journal of patient safety and risk management
container_volume 24
creator Dhawale, Tejaswini
Zech, Jennifer
Greene, Sarah M
Roblin, Douglas W
Brigham, Karen Berg
Gallagher, Thomas H
Mazor, Kathleen M
description Purpose Although open communication with patients is the established best practice after a medical error, healthcare providers’ conversations with each other in these circumstances are less studied. We identified and compared what providers identified as the most important thing to say to their peer and to the patient after a medical error. Methods and materials: This study surveyed providers about the most important thing they would say to their peers and patient regarding a hypothetical scenario depicting a delayed diagnosis of cancer. Participants included primary care physicians, oncologists, and oncology nurses. Direct content analysis was used to identify major themes and the McNemar test was used to evaluate significant differences in the providers’ references to major themes (p > 0.05). Results A total of 303 providers produced valid responses. Four major themes emerged: (1) information sharing; (2) emotion handling; (3) preventing recurrences; and (4) responsibility. While the majority of provider responses included information sharing, fewer than one-third described the event as an error. Significantly, fewer providers addressed emotion with their peer than with the patient (10% vs. 54%, p ≤ 0.001). Providers were more likely to bring up prevention of recurrences with their peer than with the patient (43% vs. 19%, p ≤ 0.001). Approximately one-quarter of providers addressed responsibility with the peer and patient (25% vs. 26%, p = 0.707), although fewer than 10% acknowledged personal responsibility for the error in either context. Conclusion Providers approach conversations about medical errors with a peer differently than with patients and may benefit from additional communication training or support.
doi_str_mv 10.1177/2516043519863578
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We identified and compared what providers identified as the most important thing to say to their peer and to the patient after a medical error. Methods and materials: This study surveyed providers about the most important thing they would say to their peers and patient regarding a hypothetical scenario depicting a delayed diagnosis of cancer. Participants included primary care physicians, oncologists, and oncology nurses. Direct content analysis was used to identify major themes and the McNemar test was used to evaluate significant differences in the providers’ references to major themes (p &gt; 0.05). Results A total of 303 providers produced valid responses. Four major themes emerged: (1) information sharing; (2) emotion handling; (3) preventing recurrences; and (4) responsibility. While the majority of provider responses included information sharing, fewer than one-third described the event as an error. Significantly, fewer providers addressed emotion with their peer than with the patient (10% vs. 54%, p ≤ 0.001). Providers were more likely to bring up prevention of recurrences with their peer than with the patient (43% vs. 19%, p ≤ 0.001). Approximately one-quarter of providers addressed responsibility with the peer and patient (25% vs. 26%, p = 0.707), although fewer than 10% acknowledged personal responsibility for the error in either context. 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We identified and compared what providers identified as the most important thing to say to their peer and to the patient after a medical error. Methods and materials: This study surveyed providers about the most important thing they would say to their peers and patient regarding a hypothetical scenario depicting a delayed diagnosis of cancer. Participants included primary care physicians, oncologists, and oncology nurses. Direct content analysis was used to identify major themes and the McNemar test was used to evaluate significant differences in the providers’ references to major themes (p &gt; 0.05). Results A total of 303 providers produced valid responses. Four major themes emerged: (1) information sharing; (2) emotion handling; (3) preventing recurrences; and (4) responsibility. While the majority of provider responses included information sharing, fewer than one-third described the event as an error. Significantly, fewer providers addressed emotion with their peer than with the patient (10% vs. 54%, p ≤ 0.001). Providers were more likely to bring up prevention of recurrences with their peer than with the patient (43% vs. 19%, p ≤ 0.001). Approximately one-quarter of providers addressed responsibility with the peer and patient (25% vs. 26%, p = 0.707), although fewer than 10% acknowledged personal responsibility for the error in either context. 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We identified and compared what providers identified as the most important thing to say to their peer and to the patient after a medical error. Methods and materials: This study surveyed providers about the most important thing they would say to their peers and patient regarding a hypothetical scenario depicting a delayed diagnosis of cancer. Participants included primary care physicians, oncologists, and oncology nurses. Direct content analysis was used to identify major themes and the McNemar test was used to evaluate significant differences in the providers’ references to major themes (p &gt; 0.05). Results A total of 303 providers produced valid responses. Four major themes emerged: (1) information sharing; (2) emotion handling; (3) preventing recurrences; and (4) responsibility. While the majority of provider responses included information sharing, fewer than one-third described the event as an error. Significantly, fewer providers addressed emotion with their peer than with the patient (10% vs. 54%, p ≤ 0.001). Providers were more likely to bring up prevention of recurrences with their peer than with the patient (43% vs. 19%, p ≤ 0.001). Approximately one-quarter of providers addressed responsibility with the peer and patient (25% vs. 26%, p = 0.707), although fewer than 10% acknowledged personal responsibility for the error in either context. Conclusion Providers approach conversations about medical errors with a peer differently than with patients and may benefit from additional communication training or support.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><doi>10.1177/2516043519863578</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0163-2061</orcidid></addata></record>
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source Applied Social Sciences Index & Abstracts (ASSIA); SAGE Journals Online
subjects Best practice
Cancer
Communication
Content analysis
Critical incidents
Delayed
Health care
Information sharing
Medical diagnosis
Medical errors
Nurses
Oncologists
Oncology
Patient communication
Patients
Peers
Primary care
Verbal communication
title We need to talk: Provider conversations with peers and patients about a medical error
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