医疗事故发生后的信息披露:从与患者、医疗团队和管理人员举办的全国性研讨会中汲取的经验教训。

IF 3.5 4区 医学 Q1 HEALTH POLICY & SERVICES
Adi Finkelstein, Mayer Brezis, Amiad Taub, Dana Arad
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引用次数: 0

摘要

背景:尽管披露医疗事故的情况越来越多,但透明度仍然是一项挑战。公认的障碍包括羞耻感、对诉讼的恐惧、纪律处分以及失去患者的信任。2018 年,以色列卫生部发起了一系列关于披露医疗事故的研讨会。参与研讨会的有医疗中心管理人员、医疗服务提供者、患者以及曾受到医疗事故伤害的患者家属。本研究介绍了在 15 次此类研讨会上所汲取的有关披露医疗事故所面临挑战的经验教训:数据收集包括 15 场研讨会的参与者观察、所有研讨会的完整录音以及详细的现场记录。结果:我们确定了四个主题:"在工作坊中,我们发现了哪些挑战?我们确定了四大主题:"医疗服务提供者认同向患者披露医疗事故的价值";"向患者披露医疗事故的情感挑战";"医学法律话语挑战透明度";以及 "医疗服务提供者和患者呼吁改变披露医疗事故的文化"。参与者的观察表明,一位曾在另一家医院经历过悲剧并愿意分享的患者的存在营造了一种亲密的氛围,使双方能够进行坦诚的对话:这项研究表明,在医疗事故发生后的保护性环境中进行公开对话具有道德、人文和教育价值。我们相信,类似的研讨会可能有助于培养医疗事故发生后的机构披露文化。我们建议卫生部将此类研讨会推广到所有医疗机构,制定指导方针,并强制要求对所有医疗服务提供者进行披露技能培训。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disclosure following a medical error: lessons learned from a national initiative of workshops with patients, healthcare teams, and executives.

Background: Despite the increase in disclosures of medical errors, transparency remains a challenge. Recognized barriers include shame, fear of litigation, disciplinary actions, and loss of patient trust. In 2018, the Israeli Ministry of Health initiated a series of workshops about disclosure of medical errors. The workshops involved medical center executives, healthcare providers, patients, and family members of patients who had previously been harmed by a medical error. This study presents the lessons learned about perceived challenges in disclosure of errors in 15 such workshops.

Methods: Data collection included participant observations in 15 workshops, full audio recordings of all of the workshops, and documentation of detailed field notes. Analysis was performed under thematic analysis guidelines.

Results: We identified four main themes: "Providers agree on the value of disclosure of a medical error to the patient"; "Emotional challenges of disclosure of medical error to patients"; "The medico-legal discourse challenges transparency"; and "Providers and patients call for a change in the culture regarding disclosure of medical errors". Participant observations indicated that the presence of a patient who had experienced a tragedy in another hospital, and who was willing to share it created an intimate atmosphere that enabled an open conversation between parties.

Conclusion: The study shows the moral, human, and educational values of open discourse in a protective setting after the occurrence of a medical error. We believe that workshops like these may help foster a culture of institutional disclosure following medical errors. We recommend that the Ministry of Health extend such workshops to all healthcare facilities, establish guidelines and mandate training for skills in disclosure for all providers.

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来源期刊
CiteScore
6.20
自引率
4.40%
发文量
38
审稿时长
28 weeks
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