Associations Between Organizational Communication and Patients’ Experience of Prolonged Emotional Impact Following Medical Errors

Abstract

BackgroundThe emotional impact of medical errors on patients may be long-lasting. Factors associated with prolonged emotional impacts are poorly understood. MethodsWe conducted a subanalysis of a 2017 survey (response rate 37% [2,536/6,891]) of US adults to assess emotional impact of medical error. Patients reporting a medical error were included if the error occurred ≥ 1 year prior. Duration of emotional impact was categorized into no/short-term impact (impact lasting < 1 month), prolonged impact (> 1 month), and especially prolonged impact (> 1 year). Based on their reported experience with communication around the error, we categorized patients experience as consistent with national disclosure guidelines, contrary to guidelines, mixed, or neither. We used multinomial regression to examine associations between patient factors, event characteristics, and organizational communication with prolonged emotional impact (> 1 month, > 1 year). ResultsOf all survey respondents, 18% (451/2,536) reported an error occurring ≥ 1 year prior. Of these, 51% (231/451) reported prolonged/especially prolonged emotional impact (31% prolonged, 20% especially prolonged). Factors associated with prolonged emotion impact included: female gender (adjusted odds ratio 2.1 [95% confidence interval 1.5–2.9]); low socioeconomic status (SES; 1.7 [1.1–2.7]); physical impact (7.3 [4.3–12.3]); no organizational disclosure and no patient/family error reporting (1.5 [1.03–2.3]); communication contrary to guidelines (4.0 [2.1–7.5]); and mixed communication (2.2 [1.3–3.7]). The same factors were significantly associated with especially prolonged emotional impact (female, 1.7 [1.2–2.5]; low SES; 2.2 [1.3–3.6]; physical impact; 6.8 [3.8–12.5]; no disclosure/reporting; 1.9 [1.2–3.2]; communication contrary to guidelines; 4.6 [2.2–9.4]; mixed communication; 2.1 [1.1–3.9]). ConclusionProlonged emotional impact affected more than half of Americans self-reporting a medical error. Organizational failure to communicate according to disclosure guidelines after patient-perceived errors may exacerbate harm, especially for patients at risk of healthcare disparities.