Patients’ Experiences with Disclosure of a Large-Scale Adverse Event
Patients’ Experiences with Disclosure of a Large-Scale Adverse Event
复制标题
患者披露大规模不良事件的经历
作者：
Carolyn D. Prouty;M. Foglia;T. Gallagher
背景当大规模不良事件影响多名患者且伤害机会极低时，医院面临披露困境。了解在此类事件后收到披露的患者的观点可以帮助机构制定与感知或真实的伤害和事件规模相称的沟通计划。方法2008年对266名华盛顿大学医学中心（UWMC）患者进行了邮寄调查，这些患者在2004年收到了关于涉及不完整内窥镜清洁过程的大规模、低伤害/低风险不良事件的书面披露。该调查衡量了患者对这一披露的满意度，他们对医疗保健结果的担忧，以及他们在类似情况下对未来沟通的建议。结果调查收到了266名合格受访者中的127名（48%）; 98%的人认为UWMC告知他们这一事件是正确的，对披露的平均满意度为7.7（0至10分）。在127名受访者中，64%的人有点或非常担心内窥镜清洁问题可能会导致他们的健康问题; 60%的人表示他们对UWMC诚实和正直的印象有所增加; 31%的人表示他们对护理质量的看法有所增加; 94%的人同意医疗机构应该告诉病人他们护理中的任何错误，即使伤害的风险很低，尽管28%的人认为这样的通知会让他们感到焦虑。报告担心该事件可能导致他们的健康问题的受访者不太可能对该机构的披露感到满意。患者指出，他们有权了解与自己的健康和医疗保健有关的信息材料，这是披露的一个重要原因。结论：大规模、低伤害/低风险事件披露的接受者绝大多数支持被告知该事件，并赞同将来通知患者类似事件。尽管告知患者可能会引起一些人的担忧，但机构应确保其披露政策和程序反映患者的偏好。
Background Hospitals face a disclosure dilemma when large-scale adverse events affect multiple patients and the chance of harm is extremely low. Understanding the perspectives of patients who have received disclosures following such events could help institutions develop communication plans that are commensurate with the perceived or real harm and scale of the event. Methods A mailed survey was conducted in 2008 of 266 University of Washington Medical Center (UWMC) patients who received written disclosure in 2004 about a large-scale, low-harm/low-risk adverse event involving an incomplete endoscope cleaning process. The survey measured patients’ satisfaction with this disclosure, their concerns about healthcare outcomes, and their recommendations for future communication, given similar circumstances. Results Surveys were received from 127 of 266 (48 percent) of eligible respondents; 98 percent thought that UWMC was right to inform them about this event, and mean satisfaction with the disclosure was 7.7 on a 0 to 10 scale. Of the 127 respondents, 64 percent were somewhat or very concerned that the endoscope cleaning problem might cause them health problems; 60 percent reported their impressions of UWMC’s honesty and integrity had increased; 31 percent said their perceptions of the quality of care had increased; 94 percent agreed that institutions should tell patients about any error in their care, even when the risk of harm was low, although 28 percent agreed that such notifications would make them anxious. Respondents who reported concern that the event could cause them health problems were less likely to be satisfied with the institution’s disclosure. Patients cited their right to know information material to their own health and healthcare as an important reason for disclosure. Conclusion Recipients of disclosure of a large-scale, low-harm/low-risk event overwhelmingly supported being told of the event and endorsed notification of patients for similar events in the future. Although informing patients may cause concern for some, institutions should ensure their disclosure policies and procedures reflect their patients’ preferences.
影响因子：
120.7
作者：
Gallagher, TH;Waterman, AD;Levinson, W
通讯作者：
Levinson, W
揭露对患者有害的医疗错误：解决三个棘手案件。
影响因子：
9.6
作者：
Gallagher,ThomasH;Bell,SigallK;Smith,KellyM;Mello,MichelleM;McDonald,TimothyB
通讯作者：
McDonald,TimothyB