Numerous organizations promote communication with patients and families after harm has occurred due to medical error. This commentary reflects on perceived barriers to patient disclosure and describes the patient and family perspectives and needs following harm. The authors promote the use of Communication and Resolution Programs (CRP) such as the learning community Pathway to Accountability, Compassion, and Transparency (PACT) to advance research, policy, and transparency regarding patient harm.

Communication with patients and caregivers is important after a diagnostic error. Using a simulated case involving delayed diagnosis of breast cancer, this study compared how crowdsourced laypeople and patient advocates rate physician disclosure communication skills. Findings suggest that patient advocates rate communication skills more stringently than laypeople, but laypeople can correctly identify physicians with high and low communication skills.

… J Patient Saf … Patient engagement and encouraging speaking … than patients in the control group. … Mazor KM, Kamineni A, Roblin DW, et al. Encouraging patients to speak up about problems in cancer care. J Patient Saf. 2021;17(8):e1278-e1284. …

This qualitative study explored the long-term impacts experienced by patients and family members involved in medical harm events. Participants described psychological, social/behavioral, and financial impacts and more than half reported ongoing physical impacts.

… J Patient Saf Risk Manag … Effective communication between … birth events: experiences of parents and clinicians. J Patient Saf Risk Manag. 2021;26(5):200–206. …

… across the VA system. … Elwy AR, Maguire EM, McCullough M, et al. From implementation to sustainment: a large-scale adverse event disclosure support program … Healthc (Amst). 2021;8 Suppl 1:100496. doi: 10.1016/j.hjdsi.2020.100496. …

… and the use of metrics to track CRP functioning.  … Gallagher TH, Boothman RC, Schweitzer L, et al. Making …

… claims. This article discusses the possibility of a medical malpractice crisis in response to poor outcomes … support that could prevent traditional legal actions. … Sage WM, Boothman RC, Gallagher TH. Another medical malpractice crisis?: Try …

This commentary discusses safety outcomes associated with late career practitioners, measuring practitioner performance, and options for practitioners with declining performance, including key features and lessons learned from early adopters of late career practitioner programs.

… Jt Comm J Qual Patient Saf … This article evaluates the … patients to speak up   about breakdowns in care. Over a three-year period at one large, community hospital, the … 4,600 patients and identified 822 (17.6%) who experienced a breakdown in care. Of those, 66.5% identified harm …

This study held focus groups with breast cancer providers to better understand attitudes and experiences regarding communicating with patients about diagnostic errors. Researchers presented three hypothetical vignettes for discussion. Participants identified challenges related specifically to breast cancer as well as challenges stemming from team-based care. To improve communication about these errors, participants recommended educating patients, being honest and empathetic, and focus on the positive and the patient’s future.

This commentary reviews general aspects of the disclosure movement, supportive evidence, and challenges associated with liability concerns. The authors discuss barriers unique to radiology that have hindered acceptance of the practice and highlight how communication-and-resolution programs can support radiologist participation in disclosure conversations.

Communication-and-resolution programs are designed to build healing relationships, offer appropriate compensation, and facilitate organizational learning after a harmful medical error. Although some success has been achieved, communication-and-resolution programs have yet to be widely implemented across the health system. This commentary discusses policy, safety outcome evidence, monetary, and program design weaknesses as prominent barriers to wide-scale implementation. The authors recommend aligning the programs to foundational concepts of safety and patient-centeredness to help drive progress.

Patients are frequently encouraged to engage with health care providers as partners in safety by speaking up and sharing their concerns. Although research has shown that patients and family members sometimes identify safety issues that might otherwise go unnoticed, they may not always be willing to speak up. In this cross-sectional study involving eight hospitals, researchers used postdischarge patient survey data to understand patients' comfort in voicing concerns related to their care. Almost 50% of the 10,212 patients who responded to the survey reported experiencing a problem during hospitalization, and 30% of those patients did not always feel comfortable sharing their concerns. An Annual Perspective summarized approaches to engaging patients and caregivers in safety efforts.

… to require that professionals retire from risky work at a certain age . Researchers interviewed health care system … as they age . Respondents emphasized patient safety as a guiding principle in addressing aging physicians' …

… Journal of patient safety … J Patient Saf … Disclosure of medical errors to patients and … involved if done incorrectly . This commentary describes a disclosure coaching initiative , including the toolkit and …

… J Hosp Med … J Hosp Med … Patients can play a crucial role in … Safety Primer and PSNet perspective . … Fisher K, Smith K, Gallagher T, Burns L, Morales C, Mazor K. We Want to Know: …

Physician skills can degrade with age. Other high-risk industries assess older practitioners to confirm cognitive and technical competency, but medicine has been slow to adopt this safety strategy. Exploring how to approach assessments of the aging physician, this review suggests that health care institutions and professional organizations should develop processes and policies that support appropriate skill review within the context of physician well-being and patient safety.

… J Patient Saf … J Patient Saf … Team training is frequently used as a strategy for improving patient safety. In keeping with …

… … Arch Pathol Lab Med … Disclosure of medical errors is a recommended patient safety practice. This focus group study …