Patient assessments of a hypothetical medical error: effects of health outcome, disclosure, and staff responsiveness.
OBJECTIVE
To assess whether patients' perceptions of a hypothetical medical error are influenced by staff responsiveness, disclosure of error, and health consequences of the error.


METHODS
Hypothetical scenario describing a medication error submitted by mail. Three factors were manipulated at random: rapid v slow staff responsiveness to error; disclosure v non-disclosure of the error; and occurrence of serious v minor health consequences.


METHODS
Patients discharged from hospital.


METHODS
Assessment of care described in the scenario as bad or very bad, rating of care as unsafe, and intent to not recommend the hospital.


RESULTS
Of 1274 participants who evaluated the scenario, 71.4% rated health care as bad or very bad, 60.2% rated healthcare conditions as unsafe, and 25.5% stated that they would not recommend the hospital. Rating health care as bad or very bad was associated with slow reaction to error (odds ratio (OR) 2.8, 95% CI 2.1 to 3.6), non-disclosure of error (OR 2.0, 95% CI 1.5 to 2.6), and serious health consequences (OR 3.4, 95% CI 2.6 to 4.5). Similar associations were observed for rating healthcare conditions as unsafe and the intent to not recommend the hospital. Younger patients were more sensitive to non-disclosure than older patients.


CONCLUSIONS
Former patients view medical errors less favorably when hospital staff react slowly, when the error is not disclosed to the patient, and when the patient suffers serious health consequences.
Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland.
A
A
Cleopas
A
A
Villaveces
A
A
Charvet
P A
PA
Bovier
V
V
Kolly
T V
TV
Perneger
D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D015285:Hospital-Patient Relations; D006785:Hospitals, University / Q000592:standards*; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000009:adverse effects / Q000523:psychology*; D008875:Middle Aged; D010351:Patient Discharge; D011787:Quality of Health Care / Q000145:classification*; D017751:Safety Management / Q000592:standards*; D011795:Surveys and Questionnaires; D013557:Switzerland; D013997:Time Factors; D014342:Truth Disclosure