Patient perspectives of patient-provider communication after adverse events.
OBJECTIVE
To explore patient perceptions of patient-provider communication after an actual adverse medical event because prior patient error studies are rarely based on real situations.


METHODS
We conducted four patient focus groups using a semi-structured guide. We analyzed transcripts using an editing approach to identify themes.


METHODS
Three sites in Colorado.


METHODS
participants were recruited from statewide post-injury program. Purposeful sampling began with patients in a geographic location; we contacted every other patient (up to 50). Twenty-two patients initially agreed to participate; 16 adults participated, representing 13 cases.


RESULTS
Complex issues and processes were involved in resolution attempts. Effective communication was an important factor in whether professional relationships continued after an adverse event. The communication nature and quality influenced whether patients defined event as 'honest mistake' or 'error'. Two types of trauma (physical and emotional) were expected and found. A third (financial) uncovered and proved in some cases the most salient factor influencing patients' subsequent actions. Caring, honest, quick, personal, and repeated provider responses were linked to patient satisfaction.


CONCLUSIONS
Provider communication timeliness and quality were important influences on patients' responses to adverse events. Confronting an adverse medical event collaboratively helped both patients and providers with patients' emotional, physical, and financial trauma and minimized the anger and frustration commonly experienced. Health organizations, providers, investigators, and policymakers should consider the patient experience when developing provider training or evaluating processes in patient resolution.
Duclos
Christine W
CW
Department of Family Medicine, University of Colorado at Denver and Health Sciences Center, Denver, CO 80238, USA. cduclos@jsi.com
Eichler
Mary
M
Taylor
Leslie
L
Quintela
Javan
J
Main
Deborah S
DS
Pace
Wilson
W
Staton
Elizabeth W
EW
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence; D003142:Communication; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000009:adverse effects / Q000523:psychology*; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D011369:Professional-Patient Relations; D013315:Stress, Psychological / Q000209:etiology; D014947:Wounds and Injuries / Q000209:etiology