Difficult Conversations in the Emergency Department: Spotlight on the Disclosure of Medical Errors

Abstract

Despite our best efforts, medical errors remain an unavoidable reality in the field of medicine, and bring with them sensitive and often-challenging communication issues. This is particularly significant in the emergency department (ED), where health care providers must stabilize, diagnose, and treat patients very quickly, all while establishing rapport and developing trust with the patient and family. The patient and family rely on the ED physician not only to provide appropriate treatment but also to alleviate anxiety. Difficult conversations in the ED span a variety of topics, including adolescent sexuality, child abuse, a new or life-threatening diagnosis, or a medical error that occurred in the course of the child's care. Ultimately, it is the physician's responsibility to ensure that communication is effective, honest, and complete. This review article aims to guide clinicians through the issues surrounding one of the most difficult conversations that can arise in the ED: the disclosure of medical errors.