Disclosure following a medical error: lessons learned from a national initiative of workshops with patients, healthcare teams, and executives

Despite the increase in disclosures of medical errors, transparency remains a challenge. Recognized barriers include shame, fear of litigation, disciplinary actions, and loss of patient trust. In 2018, the Israeli Ministry of Health initiated a series of workshops about disclosure of medical errors....

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Bibliographic Details
Published in:	Israel journal of health policy research Vol. 13; no. 1; p. 13
Main Authors:	Finkelstein, Adi, Brezis, Mayer, Taub, Amiad, Arad, Dana
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 11-03-2024 BioMed Central BMC
Subjects:	Audio data Communication Culture Data collection Dialogue Disclosure Disclosure of information Documentation Error analysis Errors Ethical aspects Executives Field study Guidelines Health care Health care facilities Health care industry Health care policy Health services Healthcare providers Hospitals Israel Listening Litigation Management Medical centers Medical errors Medical malpractice Medical research Medicine, Experimental Nurses Original Patients Physicians Shame Teams Transparency Workshops Workshops (Educational programs) Israel Dialogue Transparency Medical malpractice Listening Medical error Healthcare providers Israel Disclosure
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Summary:	Despite the increase in disclosures of medical errors, transparency remains a challenge. Recognized barriers include shame, fear of litigation, disciplinary actions, and loss of patient trust. In 2018, the Israeli Ministry of Health initiated a series of workshops about disclosure of medical errors. The workshops involved medical center executives, healthcare providers, patients, and family members of patients who had previously been harmed by a medical error. This study presents the lessons learned about perceived challenges in disclosure of errors in 15 such workshops. Data collection included participant observations in 15 workshops, full audio recordings of all of the workshops, and documentation of detailed field notes. Analysis was performed under thematic analysis guidelines. We identified four main themes: "Providers agree on the value of disclosure of a medical error to the patient"; "Emotional challenges of disclosure of medical error to patients"; "The medico-legal discourse challenges transparency"; and "Providers and patients call for a change in the culture regarding disclosure of medical errors". Participant observations indicated that the presence of a patient who had experienced a tragedy in another hospital, and who was willing to share it created an intimate atmosphere that enabled an open conversation between parties. The study shows the moral, human, and educational values of open discourse in a protective setting after the occurrence of a medical error. We believe that workshops like these may help foster a culture of institutional disclosure following medical errors. We recommend that the Ministry of Health extend such workshops to all healthcare facilities, establish guidelines and mandate training for skills in disclosure for all providers.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2045-4015 2045-4015
DOI:	10.1186/s13584-024-00599-8