Medical error disclosure among pediatricians: choosing carefully what we might say to parents.
OBJECTIVE
To determine whether and how pediatricians would disclose serious medical errors to parents.


METHODS
Cross-sectional survey.


METHODS
St Louis, Missouri, and Seattle, Washington.


METHODS
University-affiliated hospital and community pediatricians and pediatric residents. Main Exposure Anonymous 11-item survey administered between July 1, 2003, and March 31, 2004, containing 1 of 2 scenarios (less or more apparent to the child's parent) in which the respondent had caused a serious medical error.


METHODS
Physician's intention to disclose the error to a parent and what information the physician would disclose to the parent about the error.


RESULTS
The response rate was 56% (205/369). Overall, 53% of all respondents (109) reported that they would definitely disclose the error, and 58% (108) would offer full details about how the error occurred. Twenty-six percent of all respondents (53) would offer an explicit apology, and 50% (103) would discuss detailed plans for preventing future recurrences of the error. Twice as many pediatricians who received the apparent error scenario would disclose the error to a parent (73% [75] vs 33% [34]; P < .001), and significantly more would offer an explicit apology (33% [34] vs 20% [20]; P = .04) compared with the less apparent error scenario.


CONCLUSIONS
This study found marked variation in how pediatricians would disclose a serious medical error and revealed that they may be more willing to do so when the error is more apparent to the family. Further research on the impact of professional guidelines and innovative educational interventions is warranted to help improve the quality of error disclosure communication in pediatric settings.
Loren
David J
DJ
Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98195, USA. dloren@u.washington.edu
Klein
Eileen J
EJ
Garbutt
Jane
J
Krauss
Melissa J
MJ
Fraser
Victoria
V
Dunagan
W Claiborne
WC
Brownstein
Dena R
DR
Gallagher
Thomas H
TH
D000328:Adult; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000941:ethics / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital / Q000941:ethics; D008875:Middle Aged; D016017:Odds Ratio; D010290:Parents; D010372:Pediatrics / Q000941:ethics* / Q000379:methods; D010817:Physician-Patient Relations / Q000941:ethics; D010820:Physicians / Q000941:ethics; D010818:Practice Patterns, Physicians' / Q000941:ethics / Q000706:statistics & numerical data*; D011336:Probability; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014342:Truth Disclosure / Q000941:ethics*; D014481:United States