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A Better Ability to Admit Mistakes May Mitigate Medical Errors

A Better Ability to Admit Mistakes May Mitigate Medical Errors
from Dentistry Today

Errors happen in dentistry and across medicine, with the worst mistakes causing as many as 250,000 fatalities each year. Guidelines to normalize and encourage error disclosure are available to improve patient safety and healthcare outcomes, though they don’t address the psychology that influences how and when practitioners disclose errors and manage their consequences. Researchers now are calling for better education and training focused on these psychological challenges to reduce the number and severity of these errors.

“We must transform the culture of error disclosure in the medical community from one that is often punitive to one that is restorative and supportive,” said Neha Vapiwala, MD, an associate professor of radiation oncology, vice chair of education at the Perelman School of Medicine at the University of Pennsylvania, and co-author of the study. “And to do that, we must tend to the psychological challenges that medical professionals wrestle with when they face the possibility of disclosing an error.”

Initiatives such as the Disclosure, Apology, and Offer model have helped make moderate gains in creating a culture of transparency in health systems, according to the researchers. But these efforts primarily focus on the legal and financial aspects of error closure and do not address other barriers, such as the fear, shame, and guilt that come with error disclosure.

“Arguably, these psychological factors are harder to overcome, especially in this modern age of social media where healthcare providers can be reviewed and scrutinized in very public forums,” said Vapiwala. “There is real concern that any little slipup can live on the Internet for the rest of someone’s career.”

The researchers identified a pair of main cognitive biases that often hinder error disclosure: Fundamental Attribution Error, which is the tendency to overestimate one’s own role in a situation, and Forecasting Error, which is the tendency to overestimate the impact and duration of negative consequences while underestimating the ability to recover from those circumstances.

For example, if an error led to a patient injury, the physician might initially overstate his own role in that error rather than examine any systematic reasons for why that error occurred. The physician may then also overestimate the long-term consequences or recovery time for the patient, leading to feelings of both self-blame and exaggerated doom, both of which damage the physician-patient relationship and may impede a care provider from reporting the error.

“Overcoming these biases is akin to suppressing a reflex. It requires self-awareness, practice, and, most importantly, education and training,” Vapiwala said.

Read full article on DentistryToday.