Disclosure of medical errors: physicians\u2019 knowledge, attitudes and practices (KAP) in an oncology center

Razan Mansour,Amal Al-Tabba,Thalia Arawi,Asem Mansour,Khawlah Ammar,Maysa Al-Hussaini

doi:10.1186/s12910-020-00513-2

Abstract

BackgroundBetween the need for transparency in healthcare, widely promoted by patient’s safety campaigns, and the fear of negative consequences and malpractice threats, physicians face challenging decisions on whether or not disclosing medical errors to patients and families is a valid option.We aim to assess the knowledge, attitudes and practices (KAP) of physicians in our center regarding medical error disclosure.MethodsThis is a cross-sectional self-administered questionnaire study. The questionnaire was piloted and no major modifications were made.A day-long training workshop consisting of didactic lectures, short and long case scenarios with role playing and feedback from the instructors, were conducted. Physicians who attended these training workshops were invited to complete the questionnaire at the end of the training, and physicians who did not attend any training were sent a copy of the questionnaire to their offices to complete. To assure anonymity and transparency of responses, we did not query names or departments.Descriptive statistics were used to present demographics and KAP. The differences between response\\s of physicians who received the training and those who did not were analyzed with t-test and descriptive statistics. The 0.05 level of significance was used as a cutoff measure for statistical significance.ResultsEighty-eight physicians completed the questionnaire (55 attended training (62.50%), and 33 did not (37.50%)). Sixty Five percent of physicians were males and the mean number of years of experience was 16.5 years. Eighty-Seven percent (n = 73) of physicians were more likely to report major harm, compared to minor harm or no harm. Physicians who attended the workshop were more knowledgeable of articles of Jordan’s Law on Medical and Health Liability (66.7% vs 45.5%, p-value = 0.017) and the Law was more likely to affect their decision on error disclosure (61.8% vs 36.4%, p-value = 0.024).ConclusionFormal training workshops on disclosing medical errors have the power to positively influence physicians’ KAP toward disclosing medical errors to patients and possibly promoting a culture of transparency in the health care system.

Highlights

Between the need for transparency in healthcare, widely promoted by patient’s safety campaigns, and the fear of negative consequences and malpractice threats, physicians face challenging decisions on whether or not disclosing medical errors to patients and families is a valid option
Medical error disclosure is defined as “communication between a health care provider and a patient, family members, or a patient’s proxy that acknowledges the occurrence of an error, discusses what happened, and describes the link between the error and outcomes in a manner that is meaningful to the patient” [1]
The questionnaire was completed by 88 physicians working at King Hussein Cancer Center (KHCC); 55 (62.50%) received training at the workshop, and 33 (37.50%) did not

Summary

Introduction

Between the need for transparency in healthcare, widely promoted by patient’s safety campaigns, and the fear of negative consequences and malpractice threats, physicians face challenging decisions on whether or not disclosing medical errors to patients and families is a valid option. Medical error disclosure is defined as “communication between a health care provider and a patient, family members, or a patient’s proxy that acknowledges the occurrence of an error, discusses what happened, and describes the link between the error and outcomes in a manner that is meaningful to the patient” [1]. In Jordan, a study found that 28% of all hospital admissions in Jordan were affected by medical errors, with medication errors as the most common cause, followed by the wrong medical diagnosis and health care associated infections. Infections, bedsores and falls were reported by 21.3, 21.3, 16 and 8% of participants, respectively [4]. Other errors reported in the study were errors of patient identification, transfusion errors, and medical errors that lead to patients’ death

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