Reporting and disclosing medical errors: pediatricians' attitudes and behaviors.
OBJECTIVE
To characterize pediatricians' attitudes and experiences regarding communicating about errors with the hospital and patients' families.


METHODS
Cross-sectional survey.


METHODS
St Louis, Mo, and Seattle, Wash.


METHODS
University-affiliated hospital and community pediatricians and pediatric residents.


METHODS
Anonymous 68-item survey (paper or Web-based) administered between July 2003 and March 2004.


METHODS
Physician attitudes and experiences about error communication.


RESULTS
Four hundred thirty-nine pediatric attending physicians and 118 residents participated (62% response rate). Most respondents had been involved in an error (39%, serious; 72%, minor; 61%, near miss; 7%, none). Respondents endorsed reporting errors to the hospital (97%, serious; 90%, minor; 82%, near miss), but only 39% thought that current error reporting systems were adequate. Most pediatricians had used a formal error reporting mechanism, such as an incident report (65%), but many also used informal reporting mechanisms, such as telling a supervisor (47%) or senior physician (38%), and discussed errors with colleagues (72%). Respondents endorsed disclosing errors to patients' families (99%, serious; 90%, minor; 39%, near miss), and many had done so (36%, serious; 52%, minor). Residents were more likely than attending physicians to believe that disclosing a serious error would be difficult (96% vs 86%; P = .004) and to want disclosure training (69% vs 56%; P = .03).


CONCLUSIONS
Pediatricians are willing to report errors to hospitals and disclose errors to patients' families but believe current reporting systems are inadequate and struggle with error disclosure. Improving error reporting systems and encouraging physicians to report near misses, as well as providing training in error disclosure, could help prevent future errors and increase patient trust.
Garbutt
Jane
J
Department of Medicine, Washington University School of Medicine, St Louis, MO 63110, USA. jgarbutt@im.wustl.edu
Brownstein
Dena R
DR
Klein
Eileen J
EJ
Waterman
Amy
A
Krauss
Melissa J
MJ
Marcuse
Edgar K
EK
Hazel
Erik
E
Dunagan
Wm Claiborne
WC
Fraser
Victoria
V
Gallagher
Thomas H
TH
D000328:Adult; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000941:ethics / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital / Q000941:ethics / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000941:ethics; D010818:Practice Patterns, Physicians' / Q000941:ethics / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D014481:United States