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披露医疗差错的作用:医生面临的新文化挑战。

The Function of Disclosing Medical Errors: New Cultural Challenges for Physicians.

作者信息

Mendonca Vitor S, Gallagher Thomas H, de Oliveira Reinaldo A

机构信息

Division of General Internal Medicine, University of Washington - Medicine Center for Scholarship in Patient Care Quality and Safety, 1959 NE Pacific St. BB1240, Box 356526, Seattle, WA, 98109, USA.

School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.

出版信息

HEC Forum. 2019 Sep;31(3):167-175. doi: 10.1007/s10730-018-9362-7.

Abstract

A general consensus has been reached in health care organizations that the disclosure of medical errors can be a very powerful way to improve patients and physicians well-being and serves as a core component to high quality health care. This practice strongly encourages transparent communication with patients after medical errors or unanticipated outcomes. However, many countries, such as Brazil, do not have a culture of disclosing harmful errors to patients or standards emphasizing the importance of disclosing, taking responsibility, apologizing, and discussing the prevention of recurrences. Medical error is not discussed or approached during medical school. The stigma of error has a strong connection with value judgments, and emotional support for physicians does not exist. This paper suggests that open communication with the patient is essential. Guidance about error disclosure from health care organizations would be helpful for quality and patient safety and for health care professionals in countries like Brazil.

摘要

医疗保健机构已达成普遍共识,即披露医疗差错是改善患者和医生福祉的一种非常有效的方式,也是高质量医疗保健的核心组成部分。这种做法大力鼓励在出现医疗差错或意外结果后与患者进行透明沟通。然而,许多国家,如巴西,没有向患者披露有害差错的文化,也没有强调披露、承担责任、道歉以及讨论预防复发重要性的标准。医学院校期间不讨论或涉及医疗差错。差错的污名与价值判断紧密相关,而且不存在对医生的情感支持。本文认为与患者进行开放沟通至关重要。医疗保健机构提供的差错披露指导将有助于提高医疗质量和患者安全,对巴西等国的医疗保健专业人员也会有所帮助。

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