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Patient Safety and Quality

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Patient responses to medical errors depend on the timeliness and quality of the physician's communication about the event

Studies show that when things go wrong with their health care, patients need disclosure, an apology, and information about what happened and how it can be prevented from happening again. A new study shows further that how patients respond to adverse events depends on the timeliness and quality of the health care provider's communication about the event. Researchers, supported by the Agency for Healthcare Research and Quality (HS11878), conducted 4 patient focus groups (5 to 6 individuals per group) with 16 adults who had been harmed by medical error to explore their perceptions of patient-provider communication after the adverse event.

Each adverse event, including perforations, suture infections, and surgical errors, required extensive medical followup. The group facilitator explored participants' communication with their provider before, during, and after their medical injury. Effective communication was an important factor in whether professional relationships continued after an adverse event. Also, the nature and quality of provider communication influenced whether patients defined the event as an "honest mistake" or "error."

Patients who experienced an adverse event said they suffered two types of trauma, physical and emotional. However, focus group discussions also uncovered the financial trauma, such as the cost of repeated surgeries to correct the problem. In some cases, financial trauma was the dominant factor influencing patients' subsequent actions. Adverse medical events were confusing and required resolution on several levels. Often patients worked through the process feeling very alone. Frustration from poor information about their situation led to feelings of anger and a perceived need for battles or conflict, for example, via lawsuits. Caring, honest, quick, personal, and repeated provider responses were linked to less emotional trauma and greater patient satisfaction.

More details are in "Patient perspective of patient-provider communication after adverse events," by Christine W. Duclos, Ph.D., Mary Eichler, R.N., Leslie Taylor, and others, in the December 2005 International Journal for Quality in Health Care 17(6), pp. 479-486.

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