Though negative emotional impacts from medical errors can persist for years, open communication about those errors by health care providers is associated with significantly reduced feelings of sadness and depression on the part of patients and families. People are also less likely to avoid future health care encounters after an error when it is acknowledged by the health care team, according to a survey of Massachusetts residents published in BMJ Quality & Safety.
A 2018 survey by the Betsy Lehman Center for Patient Safety found that more than 20 percent of people who experienced a medical error 3 to 6 years ago still felt sad, anxious, angry, betrayed or abandoned, and over a third reported that they were avoiding medical care.
However, open communication about a medical error experience mitigated these emotional harms. People who were given information about the error and were offered a chance to talk and ask questions about the event openly with the care team or facility involved, were significantly less likely to report long-term emotional harm.
“Until now, we have lacked meaningful data about the long-term impact of communication on patients’ well-being or subsequent health-seeking behaviors.” says Julia Prentice, a co-author of the study and Research Director at the Betsy Lehman Center. “This research fills an important gap in knowledge about the effects of open communication after medical errors or adverse events.”
“We’ve known for some time that talking to patients about a medical error that occurred can prove beneficial,” said Joel S. Weissman, PhD, co-author of the study and deputy director/chief scientific officer, Center for Surgery and Public Health at Brigham and Women’s Hospital. “Now we are learning that better communication can reduce the emotional harm that patients feel after experiencing a medical error. When members of the health care team speak openly and truthfully about what happened, and provide opportunities for patients to express their feelings, the negative effects that patients have are reduced.”
“Many of us in health care have witnessed the positive impact of open communication as a driving principle, and now we have data that underscores what providers can do to help alleviate emotional harm done to patients and their families,” says another of the study’s co-authors, Sigall Bell, Director of Patient Safety and Discovery at OpenNotes, Beth Israel Deaconess Medical Center and Associate Professor of Medicine at Harvard Medical School.
Of greatest concern is the avoidance of medical care by patients or their family members after an error or adverse event. The survey found that 77 to 80 percent of respondents who received no communication about an adverse event avoided doctors and health care facilities involved in the error, but this dropped to 30 percent or less for those whose providers talked openly about what went wrong.
“This research shows patients and families are a valuable source of information on the quality and safety of health care in our state,” says Barbara Fain, Executive Director at the Betsy Lehman Center. “If there is one thing we can do today that would make a considerable difference for patients and families, it is to be more transparent and more supportive as they recover from the medical and emotional injuries they sustain.”
The article in BMJ Quality & Safety was written by Julia Prentice, PhD, research director at the Betsy Lehman Center; Sigall Bell, MD, Director of Patient Safety and Discovery at OpenNotes, Beth Israel Deaconess Medical Center and Associate Professor of Medicine at Harvard Medical School; Eric J. Thomas, MD, MPH, FACP, Director of the UTHealth – Memorial Hermann Center for Healthcare Quality and Safety; Eric C. Schneider, MD, Senior Vice President for Policy and Research at The Commonwealth Fund; Saul Weingart, MD, MPP, PhD, Chief Medical Officer at Tufts Medical Center and Professor of Medicine at Tufts University School of Medicine; Joel Weissman, PhD, Deputy Director, Chief Scientific Officer, Center for Surgery and Public Health at Brigham and Women’s Hospital; and Mark Schlesinger, PhD, Department Chair and Professor at Yale School of Public Health.
