Patients' and family members' views on how clinicians enact and how they should enact incident disclosure: the "100 patient stories" qualitative study.
Patients' and family members' views on how clinicians enact and how they should enact incident disclosure: the "100 patient stories" qualitative study.
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DOI：
10.1136/bmj.d4423
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发表时间：
2011-07-25
期刊：
影响因子：
--
通讯作者：
Gallagher TH
中科院分区：
文献类型：
--
作者：
Iedema R;Allen S;Britton K;Piper D;Baker A;Grbich C;Allan A;Jones L;Tuckett A;Williams A;Manias E;Gallagher TH
目的了解患者及家属对医疗事故披露的认知和体会，探讨有效披露的原则。设计回顾性定性研究基于100个半结构化、深度访谈患者和家属。设置澳大利亚全国范围内的多地点调查。参与者涉及严重医疗事件（导致死亡、永久残疾或长期伤害）和事件披露的39名患者和80名家庭成员。招募是通过全国性报纸（43%）、事件发生地的卫生服务（28%）、两个互联网营销公司（27%）和消费者组织（2%）进行的。主要结果测量参与者在访谈中表达的反复经历和关注。结果大多数患者和家属认为卫生服务事件披露很少能满足他们的需求和期望。他们期望为事件披露做好更充分的准备，就问题所在展开更多的对话，提供更多的后续支持，在关闭时机成熟时提供意见，以及提供更多关于后续流程改进的信息。这一分析为制定一套有效的事件披露原则提供了基础。尽管公开披露越来越突出，但关于医疗事故的讨论仍然达不到患者和家属的期望。医疗机构和提供者应加强努力，以满足患者（和家属）的需求和期望。
Objectives To investigate patients’ and family members’ perceptions and experiences of disclosure of healthcare incidents and to derive principles of effective disclosure. Design Retrospective qualitative study based on 100 semi-structured, in depth interviews with patients and family members. Setting Nationwide multisite survey across Australia. Participants 39 patients and 80 family members who were involved in high severity healthcare incidents (leading to death, permanent disability, or long term harm) and incident disclosure. Recruitment was via national newspapers (43%), health services where the incidents occurred (28%), two internet marketing companies (27%), and consumer organisations (2%). Main outcome measures Participants’ recurrent experiences and concerns expressed in interviews. Results Most patients and family members felt that the health service incident disclosure rarely met their needs and expectations. They expected better preparation for incident disclosure, more shared dialogue about what went wrong, more follow-up support, input into when the time was ripe for closure, and more information about subsequent improvement in process. This analysis provided the basis for the formulation of a set of principles of effective incident disclosure. Conclusions Despite growing prominence of open disclosure, discussion about healthcare incidents still falls short of patient and family member expectations. Healthcare organisations and providers should strengthen their efforts to meet patients’ (and family members’) needs and expectations.
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影响因子：
2.9
作者：
Iedema, Rick;Jorm, Christine;Dunn, Stewart
通讯作者：
Dunn, Stewart
影响因子：
--
作者：
Gallagher, Thomas H.;Garbutt, Jane M.;Levinson, Wendy
通讯作者：
Levinson, Wendy
影响因子：
2.6
作者：
Duclos, CW;Eichler, M;Staton, EW
通讯作者：
Staton, EW
影响因子：
39.2
作者：
Kachalia, Allen;Kaufman, Samuel R.;Rogers, Mary A. M.
通讯作者：
Rogers, Mary A. M.
影响因子：
120.7
作者：
Gallagher, TH;Waterman, AD;Levinson, W
通讯作者：
Levinson, W