Physicians' Disclosure of Medical Error to Patient/Family: The Case of Saudi Arabia

Ohood Al-Rehaili,Haya Al-Johani,Sawsan Al-Yousef

doi:10.15344/2455-2364/2019/153

Abstract

Background: Patient safety is a critical factor towards ensuring high quality healthcare. However, the rise of medical errors among physicians threatens this safety and therefore quality of healthcare. Objectives: To identify the main cause and nature of medical errors, detect main issues and challenges hindering the disclosure of these errors by physicians, and developing a background for developing constructive strategies of disclosure of these errors. Methods: A cross sectional descriptive study with data collection undertaken using self-administered two separated questionnaires to the physicians and patient families that were participating in the study. The physician questionnaire contained a total of 15 questions developed to capture the characteristics of the physicians in terms of demographic information, professional roles and their responses to two scenarios of medical errors. While the patient family questionnaire was made up of six questions that included demographic information and response to medical error disclosure by physicians. Results: Most of participating physicians admitted to disclosing medical errors that are fatal, followed by medical errors with minor or transient harm then disclosing harmful errors in patients who are hopelessly ill, the least likely type of medical error to be disclosed is errors by other doctors. Most are willing to apologize for the incident without admitting the occurrence of an error. While most of the responses of parent/guardian to medical error disclosure was given towards filing a complaint against the doctor to the administration of the hospital, followed by both complaining to a judicial official, and politely asking the doctor what led to the complication and the reason for the error, the least were towards demanding for an explanation by raising a voice to the doctor followed by taking the issue to the media. Conclusion: There is need to improve medical error disclosure of physicians to patients and their families by establishing standardized training for medical error disclosure and developing constructive strategy of medical error disclosure at nation level plus public awareness about medical errors and how to deal with it.

Highlights

Patient safety is a significant factor to high quality patient care
While most of the responses of parent/guardian to medical error disclosure was given towards filing a complaint against the doctor to the administration of the hospital, followed by both complaining to a judicial official, and politely asking the doctor what led to the complication and the reason for the error, the least were towards demanding for an explanation by raising a voice to the doctor followed by taking the issue to the media
The most common barriers related to disclosing medical errors as identified in this study include: concern of disclosure resulting to a lawsuit, harmful reaction by the patient or their family, inadequate training regarding disclosure of medical errors, harm to the patient, and difficulty towards admitting to failure, this finding is in tandem to Moffat-Bruce et al, who explicate that physician do not disclose medical error due to the lack of favorable response to this disclosure, beside the financial risk associated with disclosing medical errors as a consequence of lawsuits further inhibit the likelihood of disclosure of medical errors

Summary

Introduction

Patient safety is a significant factor to high quality patient care. Medical errors have to a large extent undermined this safety and the quality of patient care. Medical error defined as the incorrect action or plan that may or may not result in patient harm [1]. Other studies note that medical errors are a significant clinical issue and result in high rates of morbidity and mortality in healthcare setting around the world [6,7]. This is further illustrated that deaths associated with medical error in the US have been estimated to exceed the yearly number of deaths due to motor vehicle accidents, HIV/AIDS, or breast cancer.

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