The Joint Commission Journal on Quality and Patient Safety recently issued a report on how Risk Managers (those who handle claims in hospitals as part of their duties) vary from physicians in admitting errors. The report was based on anonymous surveys of nearly 3,000 risk managers and roughly 1,300 physicians.
- Risk managers have more favorable attitudes about disclosing errors to patients compared with physicians
- Risk managers were less supportive of providing a full apology
- Risk managers expressed more favorable attitudes about the mechanisms at their hospitals or health care organizations to inform physicians about errors
- Both Risk Managers and physicians agreed that there is a lot of room for improvement in systems to report errors.
The news release issued by the Joint Commission then contains the following quote:
“Fulfilling patients’ expectations for full disclosure of medical errors remains a complicated process. Our data offer additional insight into the complexities of these conversations and reflect the evolving roles of stakeholders beyond the physicians involved in the error,” says lead author David J. Loren, M.D., Assistant Professor of Medicine, Division of Pediatrics, at the University of Washington, Seattle, Washington.
Why is it so complicated? This past Friday, I reported on an article from the New England Journal of Medicine, in which the concept of acknowledging wrongdoing early in the process is central to current programs to minimize litigation costs and seek alternative methods of coping with “national tort reform legislation.”
If physicians and risk managers only had some idea of how many people we interview for potential claims and lawsuits, who are seeking legal assistance because they ‘just want to know what happened’ or who are just plain angry because no one would talk to them about what went so terribly wrong or even ,in some instances, flat-out lied to them about what happened, they might not need to do a study to conclude – there is a “lot of room for improvement.”
I know – it’s fear of lawyers that leads the health care industry to have such angst over just telling the truth. What they don’t get is that we, the lawyers, would probably have a lot less people calling us to investigate their claims if someone had just taken the time to figure out what went wrong and told the patient and/or the family the truth.