Featured Research

from universities, journals, and other organizations

Paper guides physicians' disclosure of colleagues' errors

Date:
October 30, 2013
Source:
University of Washington - Health Sciences/UW News, Community Relations & Marketing
Summary:
A position paper published gives guidance to clinicians about broaching potential medical mistakes made by co-workers. The authors attempt to reframe the meaning of "colleague."

Physicians' disclosure of errors has been studied more in the past decade than ever before, spurring rationales and guidelines for acknowledging one's own mistakes with patients. Relatively little, though, has spoken to how physicians should broach mistakes made by colleagues.

"What do I do when it's somebody else's error and I have to decide whether to say anything to the patient?"

It's the question Thomas Gallagher has fielded most often at the hundreds of error-disclosure seminars he's led. Gallagher, a general internist and UW professor of medicine and of bioethics & humanities, is lead author of "Talking with Patients about Other Clinicians' Errors," an article to be published Oct. 31 in the New England Journal of Medicine.

At its core, he said, the paper attempts to reframe what being a "colleague" means.

"What do professionalism and collegiality really call on us to do? The historical norm is that being a good colleague means not saying anything, having their back, when you think they've made a mistake. We're asking people to turn toward their colleagues in those instances," Gallagher said.

Barriers to these conversations abound: the lack of confidence in one's disclosure skills, mixed signals from healthcare institutions and malpractice insurers, and potential repercussions such as being labeled disloyal, losing referrals and the specter of litigation all contribute to the culture of physicians looking away from problems.

"Part of the change that we and others are working toward is to take away that sense of shame and stigma when care has not gone well, and make it the norm to talk with one another about quality problems," Gallagher said. "Everyone makes mistakes, so the norm should not be, 'How do I keep this to myself?'"

Broaching a potential error with a colleague is more complex than a direct "mea culpa" to a patient. Beyond the confrontation itself, there are questions of whether and when to involve other clinicians or institutional administrators. The authors warn against speculation and give guidance to fact-finding without provoking defensiveness.

Institutions should provide leadership in bringing about these conversations, the authors wrote, by strengthening "atmospheres of trust in which people are encouraged, even rewarded, for providing essential safety-related information." Many have adopted disclosure-coaching programs to help facilitate peer-to-peer discussions, the paper said.

The movement to transparency is grounded not only in an ethical obligation to patients, but also in the mandate to improve the quality of healthcare.

"That we struggle to ask colleagues to have discussions when care has not gone well is a major drag on our ability to learn from problems and prevent recurrences. Doctors are going to have to get much better with having that awkward conversation. Institutions need to figure out what they can do to support that," Gallagher said. "Being transparent is really a collective responsibility."


Story Source:

The above story is based on materials provided by University of Washington - Health Sciences/UW News, Community Relations & Marketing. Note: Materials may be edited for content and length.


Journal Reference:

  1. Thomas H. Gallagher, Michelle M. Mello, Wendy Levinson, Matthew K. Wynia, Ajit K. Sachdeva, Lois Snyder Sulmasy, Robert D. Truog, James Conway, Kathleen Mazor, Alan Lembitz, Sigall K. Bell, Lauge Sokol-Hessner, Jo Shapiro, Ann-Louise Puopolo, Robert Arnold. Talking with Patients about Other Clinicians' Errors. New England Journal of Medicine, 2013; 369 (18): 1752 DOI: 10.1056/NEJMsb1303119

Cite This Page:

University of Washington - Health Sciences/UW News, Community Relations & Marketing. "Paper guides physicians' disclosure of colleagues' errors." ScienceDaily. ScienceDaily, 30 October 2013. <www.sciencedaily.com/releases/2013/10/131030185712.htm>.
University of Washington - Health Sciences/UW News, Community Relations & Marketing. (2013, October 30). Paper guides physicians' disclosure of colleagues' errors. ScienceDaily. Retrieved July 25, 2014 from www.sciencedaily.com/releases/2013/10/131030185712.htm
University of Washington - Health Sciences/UW News, Community Relations & Marketing. "Paper guides physicians' disclosure of colleagues' errors." ScienceDaily. www.sciencedaily.com/releases/2013/10/131030185712.htm (accessed July 25, 2014).

Share This




More Health & Medicine News

Friday, July 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

AFP (July 24, 2014) A so-called drugs rehab 'clinic' is closed down in Pakistan after police find scores of ‘patients’ chained up alleging serial abuse. Duration 03:05 Video provided by AFP
Powered by NewsLook.com
Too Few Teens Receiving HPV Vaccination, CDC Says

Too Few Teens Receiving HPV Vaccination, CDC Says

Newsy (July 24, 2014) The Centers for Disease Control and Prevention is blaming doctors for the low number of children being vaccinated for HPV. Video provided by Newsy
Powered by NewsLook.com
New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

    Health News

      Environment News

        Technology News



          Save/Print:
          Share:

          Free Subscriptions


          Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

          Get Social & Mobile


          Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

          Have Feedback?


          Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
          Mobile: iPhone Android Web
          Follow: Facebook Twitter Google+
          Subscribe: RSS Feeds Email Newsletters
          Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins