Primary care physicians' willingness to disclose oncology errors involving multiple providers to patients
dc.contributor.author | Mazor, Kathleen M. | |
dc.contributor.author | Roblin, Douglas W. | |
dc.contributor.author | Greene, Sarah M. | |
dc.contributor.author | Fouayzi, Hassan | |
dc.contributor.author | Gallagher, Thomas H. | |
dc.date | 2022-08-11T08:08:33.000 | |
dc.date.accessioned | 2022-08-23T15:59:07Z | |
dc.date.available | 2022-08-23T15:59:07Z | |
dc.date.issued | 2015-11-03 | |
dc.date.submitted | 2016-02-24 | |
dc.identifier.citation | BMJ Qual Saf. 2015 Nov 3. pii: bmjqs-2015-004353. doi: 10.1136/bmjqs-2015-004353. <a href="http://dx.doi.org/10.1136/bmjqs-2015-004353">Link to article on publisher's site</a> | |
dc.identifier.issn | 2044-5415 (Linking) | |
dc.identifier.doi | 10.1136/bmjqs-2015-004353 | |
dc.identifier.pmid | 26534996 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/30589 | |
dc.description.abstract | BACKGROUND: Full disclosure of harmful errors to patients, including a statement of regret, an explanation, acceptance of responsibility and commitment to prevent recurrences is the current standard for physicians in the USA. OBJECTIVE: To examine the extent to which primary care physicians' perceptions of event-level, physician-level and organisation-level factors influence intent to disclose a medical error in challenging situations. DESIGN: Cross-sectional survey containing two hypothetical vignettes: (1) delayed diagnosis of breast cancer, and (2) care coordination breakdown causing a delayed response to patient symptoms. In both cases, multiple physicians shared responsibility for the error, and both involved oncology diagnoses. SETTING: The study was conducted in the context of the HMO Cancer Research Network Cancer Communication Research Center. PARTICIPANTS: Primary care physicians from three integrated healthcare delivery systems located in Washington, Massachusetts and Georgia; responses from 297 participants were included in these analyses. MAIN MEASURES: The dependent variable intent to disclose included intent to provide an apology, an explanation, information about the cause and plans for preventing recurrences. Independent variables included event-level factors (responsibility for the event, perceived seriousness of the event, predictions about a lawsuit); physician-level factors (value of patient-centred communication, communication self-efficacy and feelings about practice); organisation-level factors included perceived support for communication and time constraints. KEY RESULTS: A majority of respondents would not fully disclose in either situation. The strongest predictors of disclosure were perceived personal responsibility, perceived seriousness of the event and perceived value of patient-centred communication. These variables were consistently associated with intent to disclose. CONCLUSION: To make meaningful progress towards improving disclosure; physicians, risk managers, organisational leaders, professional organisations and accreditation bodies need to understand the factors which influence disclosure. Such an understanding is required to inform institutional policies and provider training. | |
dc.language.iso | en_US | |
dc.relation | <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=26534996&dopt=Abstract">Link to Article in PubMed</a> | |
dc.relation.url | http://dx.doi.org/10.1136/bmjqs-2015-004353 | |
dc.subject | Communication | |
dc.subject | Diagnostic errors | |
dc.subject | Patient-centred care | |
dc.subject | Bioethics and Medical Ethics | |
dc.subject | Health and Medical Administration | |
dc.subject | Health Services Administration | |
dc.subject | Health Services Research | |
dc.subject | Oncology | |
dc.subject | Primary Care | |
dc.title | Primary care physicians' willingness to disclose oncology errors involving multiple providers to patients | |
dc.type | Journal Article | |
dc.source.journaltitle | BMJ quality and safety | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/faculty_pubs/867 | |
dc.identifier.contextkey | 8205590 | |
html.description.abstract | <p>BACKGROUND: Full disclosure of harmful errors to patients, including a statement of regret, an explanation, acceptance of responsibility and commitment to prevent recurrences is the current standard for physicians in the USA.</p> <p>OBJECTIVE: To examine the extent to which primary care physicians' perceptions of event-level, physician-level and organisation-level factors influence intent to disclose a medical error in challenging situations.</p> <p>DESIGN: Cross-sectional survey containing two hypothetical vignettes: (1) delayed diagnosis of breast cancer, and (2) care coordination breakdown causing a delayed response to patient symptoms. In both cases, multiple physicians shared responsibility for the error, and both involved oncology diagnoses.</p> <p>SETTING: The study was conducted in the context of the HMO Cancer Research Network Cancer Communication Research Center.</p> <p>PARTICIPANTS: Primary care physicians from three integrated healthcare delivery systems located in Washington, Massachusetts and Georgia; responses from 297 participants were included in these analyses.</p> <p>MAIN MEASURES: The dependent variable intent to disclose included intent to provide an apology, an explanation, information about the cause and plans for preventing recurrences. Independent variables included event-level factors (responsibility for the event, perceived seriousness of the event, predictions about a lawsuit); physician-level factors (value of patient-centred communication, communication self-efficacy and feelings about practice); organisation-level factors included perceived support for communication and time constraints.</p> <p>KEY RESULTS: A majority of respondents would not fully disclose in either situation. The strongest predictors of disclosure were perceived personal responsibility, perceived seriousness of the event and perceived value of patient-centred communication. These variables were consistently associated with intent to disclose.</p> <p>CONCLUSION: To make meaningful progress towards improving disclosure; physicians, risk managers, organisational leaders, professional organisations and accreditation bodies need to understand the factors which influence disclosure. Such an understanding is required to inform institutional policies and provider training.</p> | |
dc.identifier.submissionpath | faculty_pubs/867 | |
dc.contributor.department | Department of Medicine, Division of Geriatric Medicine | |
dc.contributor.department | Meyers Primary Care Institute |