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Transformative possibilities of communication in medical error cases in Japan
Sawako Okamoto1, Kazuo Kawahara, Margaret Algren
1Department of Health Policy Science, Division of Health Care Management and Planning, Tokyo Medical and Dental University, Tokyo, Japan. acto2001@verizon.net
Objective:
This study examines perceptions of persons who experienced a medical error and elements that may serve to open communication with those who experienced a medical error in Japan.
Design:
Survey of individuals who reported a previous medical error in their care and those who did not.
Setting:
Tokyo, Osaka and Nagoya metropolitan areas, and in Fukuoka, Shimane and Miyagi rural townships in Japan.
Participants:
Questionnaires were distributed to 80 people who had experienced a medical error and 300 people who had not.
Main Outcome Measures:
Prevalence of views, expectations and psychological needs regarding medical error.
Results:
Forty (50%) questionnaires from those who experienced the errors and 201 (67%) from those who did not experience a medical error were completed. Among those who experienced error, 95% (38/40) preferred to be informed of a medical error immediately by senior personnel (57.7%: 23/40). Those who had not experienced error preferred to be informed by a directly responsible provider (87.6%: 176/201). The perception differences regarding who should break bad news showed statistical significance (P<0.001). Respondents reports that 'communication', 'apology' and 'corrective actions' can contribute to promoting resolution.
Conclusions:
This study showed that after the immediate disclosure of a medical error by senior medical personnel and medical providers should create an environment to continue 'communication' in order to accommodate shifting perspectives of those who experienced the error.
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