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Disclosing and reporting medical errors: Cross-sectional survey of Swiss anaesthesiologists
Stuart R McLennan1, Sabrina Engel-Glatter, Andrea H Meyer
1From the Institute for Biomedical Ethics, Universität Basel, Basel, Switzerland (SRM, SE-G, BSE), Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, Australia (SRM), Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel (AHM), Swiss Patient Safety Foundation, Zurich (DLBS), Institute of Social and Preventive Medicine, University of Bern, Bern (DLBS), Department of Anesthesia, University of Basel, Basel, Switzerland (DHS).
Background:
There is limited research on anaesthesiologists' attitudes and experiences regarding medical error communication, particularly concerning disclosing errors to patients.
Objective:
To characterise anaesthesiologists' attitudes and experiences regarding disclosing errors to patients and reporting errors within the hospital, and to examine factors influencing their willingness to disclose or report errors.
Design:
Cross-sectional survey.
Setting:
Switzerland's five university hospitals' departments of anaesthesia in 2012/2013.
Participants:
Two hundred and eighty-one clinically active anaesthesiologists.
Main Outcome Measures:
Anaesthesiologists' attitudes and experiences regarding medical error communication.
Results:
The overall response rate of the survey was 52% (281/542). Respondents broadly endorsed disclosing harmful errors to patients (100% serious, 77% minor errors, 19% near misses), but also reported factors that might make them less likely to actually disclose such errors. Only 12% of respondents had previously received training on how to disclose errors to patients, although 93% were interested in receiving training. Overall, 97% of respondents agreed that serious errors should be reported, but willingness to report minor errors (74%) and near misses (59%) was lower. Respondents were more likely to strongly agree that serious errors should be reported if they also thought that their hospital would implement systematic changes after errors were reported [(odds ratio, 2.097 (95% confidence interval, 1.16 to 3.81)]. Significant differences in attitudes between departments regarding error disclosure and reporting were noted.
Conclusion:
Willingness to disclose or report errors varied widely between hospitals. Thus, heads of department and hospital chiefs need to be aware of the importance of local culture when it comes to error communication. Error disclosure training and improving feedback on how error reports are being used to improve patient safety may also be important steps in increasing anaesthesiologists' communication of errors.
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