OBJECTIVE: To describe how Italian clinicians disclose medical errors with clear and shared lines of responsibility.To describe how Italian clinicians disclose medical errors with clear and shared lines of responsibility. METHODS: Thirty-eight volunteers were video-recorded in a simulated conversation while communicating a medical error to a simulated family member (SFM). They were assigned to a clear responsibility error scenario or a shared responsibility one. Simulations were coded for: mention of the term "error" and apology; communication content and affect using the Roter Interaction Analysis System. SFMs rated their willingness to have the patient continue care with the clinician. RESULTS: Clinicians referred to an error and/or apologized in 55% of the simulations. The error was disclosed more frequently in the clear responsibility scenario (p<0.02). When the "error" was explicitly mentioned, the SFM was more attentive, sad and anxious (p≤0.05) and less willing to have the patient continue care (p<0.05). Communication was more patient-centered (p<0.05) and affectively dynamic with the SFMs showing greater anxiety, sadness, attentiveness and respectfulness in the clear responsibility scenario (p<0.05). CONCLUSIONS: Disclosing errors is not a common practice in Italy. Clinicians disclose less frequently when responsibility is shared and indicative of a system failure. PRACTICE IMPLICATIONS: Training programs to improve disclosure practice considering the type of error committed should be implemented.
Error disclosure and family members' reactions : does the type of error really matter? / D. Leone, G. Lamiani, E. Vegni, S. Larson, D.L. Roter. - In: PATIENT EDUCATION AND COUNSELING. - ISSN 0738-3991. - 98:4(2015 Apr 13), pp. 446-452. [10.1016/j.pec.2014.12.011]
Error disclosure and family members' reactions : does the type of error really matter?
D. LeonePrimo
;G. LamianiSecondo
;E. Vegni;
2015
Abstract
OBJECTIVE: To describe how Italian clinicians disclose medical errors with clear and shared lines of responsibility.To describe how Italian clinicians disclose medical errors with clear and shared lines of responsibility. METHODS: Thirty-eight volunteers were video-recorded in a simulated conversation while communicating a medical error to a simulated family member (SFM). They were assigned to a clear responsibility error scenario or a shared responsibility one. Simulations were coded for: mention of the term "error" and apology; communication content and affect using the Roter Interaction Analysis System. SFMs rated their willingness to have the patient continue care with the clinician. RESULTS: Clinicians referred to an error and/or apologized in 55% of the simulations. The error was disclosed more frequently in the clear responsibility scenario (p<0.02). When the "error" was explicitly mentioned, the SFM was more attentive, sad and anxious (p≤0.05) and less willing to have the patient continue care (p<0.05). Communication was more patient-centered (p<0.05) and affectively dynamic with the SFMs showing greater anxiety, sadness, attentiveness and respectfulness in the clear responsibility scenario (p<0.05). CONCLUSIONS: Disclosing errors is not a common practice in Italy. Clinicians disclose less frequently when responsibility is shared and indicative of a system failure. PRACTICE IMPLICATIONS: Training programs to improve disclosure practice considering the type of error committed should be implemented.File | Dimensione | Formato | |
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