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Pediatric Clinician Comfort Discussing Diagnostic Errors for Improving Patient Safety: A Survey. | LitMetric

AI Article Synopsis

  • - Clinicians are less comfortable discussing diagnostic errors compared to other medical errors, creating challenges for meaningful conversations in safety cultures.
  • - A survey of 838 pediatric clinicians revealed significant barriers to openly discussing diagnostic errors, including fears of judgment and damage to reputation.
  • - Encouraging open discussions about diagnostic errors is critical for improving safety culture and reducing harm in healthcare settings.

Article Abstract

Introduction: Meaningful conversations about diagnostic errors require safety cultures where clinicians are comfortable discussing errors openly. However, clinician comfort discussing diagnostic errors publicly and barriers to these discussions remain unexplored. We compared clinicians' comfort discussing diagnostic errors to other medical errors and identified barriers to open discussion.

Methods: Pediatric clinicians at 4 hospitals were surveyed between May and June 2018. The survey assessed respondents' comfort discussing medical errors (with varying degrees of system versus individual clinician responsibility) during morbidity and mortality conferences and privately with peers. Respondents reported the most significant barriers to discussing diagnostic errors publicly. Poststratification weighting accounted for nonresponse bias; the Benjamini-Hochberg adjustment was applied to control for false discovery (significance set at < 0.018).

Results: Clinicians (n = 838; response rate 22.6%) were significantly less comfortable discussing all error types during morbidity and mortality conferences than privately ( < 0.004) and significantly less comfortable discussing diagnostic errors compared with other medical errors ( < 0.018). Comfort did not differ by clinician type or years in practice; clinicians at one institution were significantly less comfortable discussing diagnostic errors compared with peers at other institutions. The most frequently cited barriers to discussing diagnostic errors publicly included feeling like a bad clinician, loss of reputation, and peer judgment of knowledge base and decision-making.

Conclusions: Clinicians are more uncomfortable discussing diagnostic errors than other types of medical errors. The most frequent barriers involve the public perception of clinical performance. Addressing this aspect of safety culture may improve clinician participation in efforts to reduce harm from diagnostic errors.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190246PMC
http://dx.doi.org/10.1097/pq9.0000000000000259DOI Listing

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