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Journal Article > Commentary
Disclosure of medical errors: ethical considerations for the development of a facility policy and organizational culture change.
Henry LL. Policy Polit Nurs Pract. 2005;6:127-134.
The author discusses the history of error disclosure, the role that respect for patient autonomy plays in developing disclosure policies, and the culture change that must occur to implement such a policy.
Journal Article > Review
Aftermath of an adverse event: supporting health care professionals to meet patient expectations through open disclosure.
Manser T, Staender S. Acta Anaesthesiol Scand. 2005;49:728-734.
The authors explain elements of successful disclosure, including how health care organizations can encourage it.
Kowalczyk L. The Boston Globe. November 5, 2005;Metro/Region section:A1.
This article reports on a proposed health care bill in Massachusetts that would require hospitals to disclose serious errors as well as waive costs for patients involved in errors.
Journal Article > Study
Error or "act of God"? A study of patients' and operating room team members' perceptions of error definition, reporting, and disclosure.
Espin S, Levinson W, Regehr G, Baker GR, Lingard L. Surgery. 2006;139:6-14.
This study discovered both similarities and differences in the way surgeons, nurses, anesthesiologists, and patients responded to four scripted clinical error scenarios. Findings suggested that all groups incorporated a negative outcome or a deviation from standard of practice into their error definition rather than analyzing the event independent of those factors. In addition, noted differences existed between patients who supported reporting for all negative events and nurses who believed in selective reporting. Similarly, persistent gaps existed between the full disclosure patients expect and the partial disclosure health professionals believe should occur. While the study represents a small sample size from two tertiary institutions, it does emphasize the importance of a safety culture and the need to redefine errors as opportunities for learning and improvement rather than individual or isolated events.
A Consensus Statement of the Harvard Hospitals. Burlington: Massachusetts Coalition for the Prevention of Medical Errors; 2006.
This consensus paper of the Harvard-affiliated hospitals was prepared by clinicians, risk managers, and patients to provide an in-depth understanding of preventable adverse events, their impact on patients, families, and providers, and how to manage such events. The report provides detailed guidelines based on the premise that all care should be safe and patient-centered and that all actions require full disclosure. In addition to offering recommendations on how to effectively communicate with patients and families, the report discusses support for caregivers and a detailed strategy for institutions to respond to such events in a timely and appropriate fashion. Finally, the comprehensive report offers several appendices that include recommendations and a case study on communicating with patients and families.