Study Finds Differences Among Doctors, Risk Managers in Admitting Errors

(OAKBROOK TERRACE, Ill. - February 18, 2010) Differences in attitudes among physicians and risk managers about revealing medical errors to patients may diminish the effectiveness of such disclosures, according to a new study published in the March 2010 issue of The Joint Commission Journal on Quality and Patient Safety.

The study, "Risk Managers, Physicians, and Disclosure of Harmful Medical Errors," based on anonymous surveys of nearly 3,000 risk managers and roughly 1,300 physicians, showed that risk managers have more favorable attitudes about disclosing errors to patients compared with physicians.  Risk managers, however, were less supportive of providing a full apology.  Risk managers also expressed more favorable attitudes about the mechanisms at their hospitals or health care organizations to inform physicians about errors, but, like physicians, reported that there is much room for improvement in systems to report errors.

The authors of the study urge closer collaboration between risk managers and physicians in the disclosure process. They also advise it's important that hospital policies make clear who has final authority over whether and how disclosures to patients will take place. 

"Fulfilling patients' expectations for full disclosure of medical errors remains a complicated process. Our data offer additional insight into the complexities of these conversations and reflect the evolving roles of stakeholders beyond the physicians involved in the error," says lead author David J. Loren, M.D., Assistant Professor of Medicine, Division of Pediatrics, at the University of Washington, Seattle, Washington.

Rick Iedema, Ph.D., Director, Centre for Health Communication, at the University of Technology, Sydney, Australia, noted in an accompanying editorial, "Attitudes Towards Disclosure Need to Engage with Systems Thinking," that the study suggests that professional attitudes toward disclosure communication-although encouraging in other respects-remain out of alignment with health care organizational learning about safety and systems thinking.  "Adopting a systems perspective means that health care professionals frame their responsibility not as being either technical or personal, but as holistic," says Iedema.
The Joint Commission Journal on Quality and Patient Safety, published monthly by Joint Commission Resources, features peer-reviewed research and case studies on improving quality and patient safety in health care organizations.  To subscribe to The Joint Commission Journal on Quality and Patient Safety, please call JCR Customer Service toll-free at 800.746.6578, or visit