What makes an error unacceptable? A factorial survey on the disclosure of medical errors

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
David L B Schwappach, Christian M Koeck

Abstract

Although the importance of disclosing medical errors to patients has been argued, little is known about the relative effect of different attributes of error handling and communication on patients' judgments about errors. This study investigates how different characteristics of medical errors and of physicians' subsequent handling of errors contribute to patients' evaluations of the incident and their attitudes towards potential consequences and sanctions for the physician. A factorial survey using the vignette technique presented hypothetical scenarios involving medical errors to members of the general public in an Internet-based study. Members of a German Internet survey panel participated (n = 1017). Multiple ordered logistic regression models were estimated to explain citizens' judgments of error severity and their attitudes towards reporting of errors, wishing for referral to another physician, and supporting sanctions against the health professional involved as a response to characteristics of the presented errors. While the severity of the outcomes of errors remains the most important single factor in the choice of actions to be taken, the professional's approach to the error is regarded as essential in the overall evalua...Continue Reading

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