Anatomic Pathologists' Attitudes and Experiences Regarding Error Disclosure
SM Dintzis, TH Gallagher. University of Washington, Seattle, WA
Background: The patient safety movement emphasizes not only error reduction but also the importance of greater transparency in the discussion of medical errors with affected patients. Pathologists face unique challenges related to error disclosure since they traditionally have limited direct patient contact. This study describes attitudes and experiences of anatomic pathologists in the Pacific Northwest toward error disclosure.
Design: 260 practicing anatomic pathologists belonging to the Pacific Northwest Society of Pathologists and/or the Washington State Society for Pathologists were invited to participate in a self-administered mailed survey in April of 2009. The survey included questions regarding estimated error rates, barriers to and experience with error disclosure. Additional questions measuring participant demographics, practice experience and environment were also included.
Results: The survey was returned by 114 of 260 pathologists (44%). Ninety three percent of anatomic pathologists have been personally involved with pathology errors: 88% with a near miss, 79% with a minor error and 53% with a serious error. Only 17% of respondents reported disclosing a serious error and 4% a minor error directly to a patient. Of the pathologists having disclosed serious pathology error directly to a patient, 94% reported satisfaction with the results of the disclosure conversation. All pathologists who reportedly disclosed minor pathology error to a patient reported satisfaction with the disclosure conversation. Anatomic pathologists generally supported disclosure; 96% of respondents agreed that serious errors should be disclosed to patients. However, their beliefs varied as to which less harmful errors should be disclosed. Only 75% believed that minor errors should be disclosed and 21% agreed that near misses should be revealed. Respondents were split in their beliefs regarding the cause of medical errors: 59% believed that they are due to failures of care delivery systems, not individuals, while 41% disagreed.
Conclusions: The vast majority of anatomic pathologists have experience with error; however, only a small percentage has experience disclosing error. Pathologists generally support error disclosure to patients, but a significant gap exists between pathologists' expressed interest in disclosure and current practice.
Category: Quality Assurance
Tuesday, March 23, 2010 11:00 AM
Platform Session: Section H 2, Tuesday Morning