Medical error disclosure policy

Jawahar kalra, phd frcpc, k lorne massey, md, and amith mulla, mb bs. Selective disclosure is described in a prominent study as hiding errors that are likely to trigger lawsuits, cost a lot, or both. A risk management resource to manage liability in the healthcare practice 2 insurance provisions to consider the medical professional liability policy may expressly. Many, but not all, jurisdictions now require some form of reporting of medical errors occurring in a hospital setting. One of the biggest challenges to implementing a transparent disclosure policy is resistance from people who feel their job is threatened by a new approach to medical errors and malpractice. Error reporting and disclosure patient safety and quality ncbi. Oct 18, 2010 a policy of open disclosure standard that demands disclosure of critical events by the provider or the institution was promulgated in 2001 by the joint commission on accreditation of healthcare organizations jcaho and is now reflected in similar initiatives in the uk, canada, and australia 812. States such as california and florida mandate disclosure to patients. Va policy to disclose errors in medical care not always followed. Nevertheless, the available evidence suggests that full disclosure of medical errors may be uncommon 57. Rather than disclose all medical errors, the model leaves hospitals free to cherrypick which errors to disclose. Which medical error to disclose to patients and by whom.

A guide for education and practice, a boston childrens hospital intensive care physician, and a professor of medical ethics, anesthesiology, and pediatrics. Patients expect health care providers to promptly disclose mistakes and apologize for harmful errors. Full disclosure of harmful medical errors help with the human resources aspect of the healthcare institutions. Medical error disclosure policy takes planning, team effort. In may 2016, the agency for healthcare research and quality introduced the candor toolkit, a free resource to help hospitals adopt this same approach. Physicians have traditionally shied away from discussing errors with patients, in. Oct 01, 2002 disclosure to patients of medical errors and near misses is the most recent imperative to the health care industry from the joint commission on the accreditation of healthcare organizations. Patient safety is a much bigger problem in developing countries, based on the number of preventable deaths from medical errors, compared with reports from developed economies. Medical error disclosure and risk of malpractice litigation. Truog also is a coauthor of talking with patients and families about medical error.

Disclosure to patients of medical errors and near misses is the most recent imperative to the health care industry from the joint commission on the accreditation of healthcare organizations. But some protection may be at hand in the form of several laws recently passed by congress that aim to relieve both. Content of medical error disclosures journal of ethics. Adverse drugrelated events are common in both the inpatient and the outpatient setting. Lammico requires planners, speakers, faculty and all those who influence the content of a cme activity to disclose any financial relationships they have with commercial interests that are relevant to the cme activity. Copyrighted this document is a work product of coverys risk management department. In woods view, the disclosure policy established by the vha begun by thenmedical director steven kraman at the lexington, ky, veterans affairs medical center was the seminal event for disclosure programs. Policies, prevention, remediation march 20, 2014 by. The college of physicians and surgeons of quebec has no distinct policy on adverse event disclosure to patients, but synthesizes the concept of disclosure in its code of ethics. Ann arborbased university of michigan health system has been widely recognized for its innovative medical error disclosure policy called the michigan model. This proved to be the case at the danafarber cancer institute in boston, massachusetts, when a policy was created in 2002. Adverse patient events, errors andor unanticipated outcomes sample. Based on an extensive examination of the extant medical error disclosure.

In may 2016, the agency for healthcare research and quality introduced the candor toolkit, a free resource to help hospitals adopt this. The foremost justification is to safeguard public trust in the medical profession, and the responsibility to disclose medical errors is acknowledged in codes of professional ethics. Jan 07, 2014 furthermore, while disclosure of medical errors by physicians to patients is unequivocally recommended by the american medical association code of medical ethics, u. Sharon muza, bs, lcce, facce, cdbdtdona, cle has been an active perinatal professional since 2004, teaching lamaze classes to thousands of families and doulaing through her private practice in seattle, wa. To a physician, the word conjures the threat of a malpractice lawsuit and the reality of escalating insurance costs. Va officials in washington declined requests for an interview on disclosure policy. The mrp is the physician who has primary responsibility for managing the medical care of a patient at a specific point in time. Jun 12, 2018 in recent years, employees disclosure of medication information to their employers has become a frontline topic for drug free workplace policy development, human resource departments, and safety initiatives in u. Operating policies and procedures disclosure policy and procedures as amended 1 january 2019 1. To help physicians with revealing errors, sorry works, an advocacy organization for disclosure, apology, and upfront compensation after adverse medical events, has a disclosure program predicated on a threestep disclosure process. This video, coproduced by stratus center for medical simulation and the center for professionalism and peer support at brigham and womens hospital, uses a case based approach to demonstrate how.

Jul 07, 2016 many, but not all, jurisdictions now require some form of reporting of medical errors occurring in a hospital setting. Va policy to disclose errors in medical care not always. Jul 07, 2009 in another study, hickson and colleagues interviewed mothers of infants who had experienced permanent injuries or deaths and found that 24% of families who sued their healthcare providers recognized a coverup. Operating policies and procedures disclosure policy and. A disclosure policy implemented by the veterans affairs va medical center in. Patients and, when appropriate, their families have a right to be informed about outcomes of care including unanticipated outcomes related to a significant medical. In woods view, the disclosure policy established by the vha begun by then medical director steven kraman at the lexington, ky, veterans affairs medical center was the seminal event for disclosure programs. Such a system can result using clear disclosure policies and procedures sensitive to patient and family needs, open communications with concerned, committed, and compassionate system representatives, and use of mediation methods that foster communication, allow for venting, and are flexible in their approach to resolving conflict, including. This chapter examines reporting of health care errors e. Disclosure of medical errors and risk mitigation susan d.

On the basis of previous literature and multiple applications of the evidencebased theory of cpm, we developed our management model for mistake disclosure. Liability, medical error legislation the hospitalist. In 2006, the national quality forum endorsed full disclosure of serious unanticipated outcomes as one of its 30 safe practices for health care. Policy, training, and support for disclosure written policies may help healthcare organizations establish a standard for what and when to disclose gallagher et al. In the same year, the cps of manitoba approved a policy requiring full disclosure. Work from global organizations is refining the right way to disclose errors. Jun 16, 2016 the institute of medicines 1999 report to err is human. Building a safer health system drew attention to medical errors and the need for improving quality and safety in medicine.

Disclosing medical errors the right way acp internist. This information is intended to provide general guidelines for risk management. Theoretically, disclosure of medical mistakes would be facilitated if those involved in health care viewed disclosure of errors and near misses as the aviation industry does, namely, as vital to the overall improvement of the system. What will be appropriate in the circumstances will vary according to the situation. An analysis of the legal and policy issues portland, me. Sample osce checklist medical error disclosure label. Aug 08, 2014 this video, coproduced by stratus center for medical simulation and the center for professionalism and peer support at brigham and womens hospital, uses a case based approach to demonstrate how. Disclosure of harm for further information regarding apologies. So, while many investigators continue their efforts to reduce the incidence of errors, others have focused on understanding how best to communicate with patients and their families after errors occur. Disclosure of nonharmful medical errors and other events. Disclosure of errors and adverse events is now endorsed by a broad array of organizations.

Much attention has focused on the management of medical mistakes in recent years. Beyond duties to the patient and physician, the student has a responsibility to him or herself to practice responsible medicine. A conceptual model for disclosure of medical errors. We read with great interest the article by chamberlain et al 1 on disclosure of nonharmful medical errors and other events. Physician assistants and the disclosure of medical error. Structuring patient and family involvement in medical. Medical error disclosure policy takes planning, team. How to and not to disclose medical errors to patients. Studies of hospitalized patients find that up to 6. The law presents tremendous legal barriers to provider efforts to discuss medical errorsfor example, contractor law generally limits liability to individual providers. The american college of emergency physicians acep believes that emergency physicians should provide prompt and truthful information to patients or their representatives about their medical conditions and treatments. In addition, recent hospital accreditation standards and some state laws require that patients be informed about unanticipated outcomes in their care 4. Furthermore, while disclosure of medical errors by physicians to patients is unequivocally recommended by the american medical association code of medical ethics, u. In 2002, the college of physicians and surgeons cps of saskatchewan was the first provincial authority in canada to release a policy on disclosure of aes and errors that occur in the course of patient care.

In another study, hickson and colleagues interviewed mothers of infants who had experienced permanent injuries or deaths and found that 24% of families who sued their healthcare providers recognized a coverup. Many patients harmed by a medical error never learn of the error. Disclosure of medical errors purpose to define policies and procedures related to disclosure of medical errors to patients and, when appropriate, their families. A policy of open disclosure standard that demands disclosure of critical events by the provider or the institution was promulgated in 2001 by the joint commission on accreditation of healthcare organizations jcaho and is now reflected in similar initiatives in the uk, canada, and australia 812. Since 2001, the joint commission has required disclosure of unanticipated outcomes of care. Since 2004, the um health system has been in the national spotlight for its innovative approach to medical errors, mishaps and nearmisses and their potential legal consequences including malpractice suits. Medication disclosure in the workplace current compliance. One million or more total medical errors are estimated to occur annua. Ethicists have long endorsed the full disclosure of medical errors to patients.

Structuring patient and family involvement in medical error. Operating policies and procedures disclosure policy. The content is not intended to substitute for professional medical advice, diagnosis, or treatment. It is not intended and should not be construed as legal or medical advice. Pennsylvania actually requires hospitals to issue a written disclosure within 7. The full disclosure policy of vamc lexington resulted in unanticipated financial benefits to the medical center. But there is also growing interest in determining how patien. In a written statement, the va said its policy of disclosing errors in care is consistent with the practices of. Never disregard professional medical advice or delay in seeking it because of something you have read in a public groups. Decades ago, physicians didnt give much thought to medical errors, truog explains. By pursuing disclosure, the student further ensures that peers will not be required to maintain silence when other medical mistakes occur. Interprofessional error disclosure training for medical.