We need to talk: Provider conversations with peers and patients about a medical error. Issue 4 (August 2019) - Dhawale, Tejaswini
Purpose: Although open communication with patients is the established best practice after a medical error, healthcare providers' conversations with each other in these circumstances are less studied. We identified and compared what providers identified as the most important thing to say to their peer and to the patient after a medical error. Methods and materials: This study surveyed providers about the most important thing they would say to their peers and patient regarding a hypothetical scenario depicting a delayed diagnosis of cancer. Participants included primary care physicians, oncologists, and oncology nurses. Direct content analysis was used to identify major themes and the McNemar test was used to evaluate significant differences in the providers' references to major themes (p > 0.05). Results: A total of 303 providers produced valid responses. Four major themes emerged: (1) information sharing; (2) emotion handling; (3) preventing recurrences; and (4) responsibility. While the majority of provider responses included information sharing, fewer than one-third described the event as an error. Significantly, fewer providers addressed emotion with their peer than with the patient (10% vs. 54%, p ≤ 0.001). Providers were more likely to bring up prevention of recurrences with their peer than with the patient (43% vs. 19%, p ≤ 0.001). Approximately one-quarter of providers addressed responsibility with the peer and patient (25% vs. 26%, p = 0.707), although fewer than 10% acknowledged personal responsibility for the error in either context. Conclusion: Providers approach conversations about medical errors with a peer differently than with patients and may benefit from additional communication training or support.