Healthcare :: Patients’ broad definition of medical errors can undermine satisfaction with care

Hospital patients define medical errors much more broadly than the traditional clinical definitions of medical errors. The patient definition of medical errors includes communication problems, responsiveness and falls, according to a new study published in the January 2007 issue of the Joint Commission Journal on Quality and Patient Safety.

The findings point out the need for physicians and other health care professionals to clarify what patients mean when they talk about an “error” or “mistake.” The study of more than 1,600 patients at 12 midwestern hospitals also shows the importance of explaining exactly what is meant by the term “medical error” if patients are to be effectively engaged in programs to prevent them.

The study-“Patients’ Concerns About Medical Errors During Hospitalization”-concludes that most patients felt a high level of medical safety, but 39 percent experienced concern about at least a single type of medical error during their hospitalization. Certain groups of patients were more likely to be concerned about medical errors, such as middle-aged patients, parents of pediatric patients and blacks. In addition, patients who experience longer lengths of stay, more severe illnesses or were admitted through the emergency department were likely to experience more concerns. Patients who received care in small and rural hospitals reported the fewest types of concerns, regardless of the severity of illness. The authors of the study, led by Thomas E. Burroughs, Ph.D., at St. Louis University, and his collaborators at Washington University and elsewhere, note that programs to educate patients to play a more active role in preventing errors may need to be tailored to effectively address the fears and concerns of each patient.

“The study underscores that patients and clinicians can have different views of the things that constitute a medical error,” says Dr. Burroughs. “For patients, clear communication and responsiveness are particularly important. If these are lacking, patients may view this as a medical error. It is important that clinicians recognize these differences, and the importance of communication and responsiveness.”

Other notable findings in the study include:

— A strong link exists between a patient’s concerns about medical errors and his/her satisfaction with the entire hospital experience. A single concern was tied to a significantly reduced likelihood of recommending and returning to the hospital for future care. It is important to note that these are “concerns,” not necessarily actual errors. For patients, it appears that error-related concerns alone, even if not linked to an actual error, are enough to significantly affect their perceptions of the entire experience, which could alter adherence and willingness to return for care.

— A recommendation that hospitals consider routine measurement of patient concerns about medical errors as part of patient satisfaction efforts. Ideally, such measurements would take place in real time, allowing health care providers to respond directly to patients’ concerns. Even if such concerns are measured retrospectively, assessing patient fears about medical errors could guide ongoing quality improvement activities and help gauge the effectiveness of patient safety efforts.

— The need for additional research into the factors that generate concerns among patients about medical errors, how best to encourage patients to express these concerns, and what strategies effectively reassure patients about their medical safety. Incorporating patient attitudes into safety programs could help prevent medical errors and enhance patient satisfaction with their health care experience.

The Joint Commission Journal on Quality and Patient Safety, published monthly by Joint Commission Resources, features peer-reviewed research and case studies on improving quality and safety in health care organizations. JCR is an affiliate of the Joint Commission on Accreditation of Healthcare Organizations.

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