Reporting and disclosing medical errors: pediatricians' attitudes and behaviors

Jane Garbutt, Dena R Brownstein, Eileen J Klein, Amy Waterman, Melissa J Krauss, Edgar K Marcuse, Erik Hazel, Wm Claiborne Dunagan, Victoria Fraser, Thomas H Gallagher
Archives of Pediatrics & Adolescent Medicine 2007, 161 (2): 179-85

OBJECTIVE: To characterize pediatricians' attitudes and experiences regarding communicating about errors with the hospital and patients' families.

DESIGN: Cross-sectional survey.

SETTING: St Louis, Mo, and Seattle, Wash.

PARTICIPANTS: University-affiliated hospital and community pediatricians and pediatric residents.

MAIN EXPOSURE: Anonymous 68-item survey (paper or Web-based) administered between July 2003 and March 2004.

MAIN OUTCOME MEASURES: Physician attitudes and experiences about error communication.

RESULTS: Four hundred thirty-nine pediatric attending physicians and 118 residents participated (62% response rate). Most respondents had been involved in an error (39%, serious; 72%, minor; 61%, near miss; 7%, none). Respondents endorsed reporting errors to the hospital (97%, serious; 90%, minor; 82%, near miss), but only 39% thought that current error reporting systems were adequate. Most pediatricians had used a formal error reporting mechanism, such as an incident report (65%), but many also used informal reporting mechanisms, such as telling a supervisor (47%) or senior physician (38%), and discussed errors with colleagues (72%). Respondents endorsed disclosing errors to patients' families (99%, serious; 90%, minor; 39%, near miss), and many had done so (36%, serious; 52%, minor). Residents were more likely than attending physicians to believe that disclosing a serious error would be difficult (96% vs 86%; P = .004) and to want disclosure training (69% vs 56%; P = .03).

CONCLUSIONS: Pediatricians are willing to report errors to hospitals and disclose errors to patients' families but believe current reporting systems are inadequate and struggle with error disclosure. Improving error reporting systems and encouraging physicians to report near misses, as well as providing training in error disclosure, could help prevent future errors and increase patient trust.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"