Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA; Program in Bioethics and Humanities, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Patient Educ Couns. 2021 May;104(5):989-993. doi: 10.1016/j.pec.2020.11.035. Epub 2020 Nov 28.
Communication about medical errors with patients and families demonstrates respect, compassion, and commitment by providing information, acknowledging harm, and maintaining trust through a process of dialogue that involves multiple conversations. This communication requires knowledge, skills, and attitudes that allow healthcare professionals to discuss facts transparently, take responsibility for what happened, and express regret and (as appropriate) apologize; these abilities also allow professionals to describe what will happen next for the patient and explain what will be done to prevent the error from happening to others in the future. Communication about medical errors also encompasses two other contexts: reporting information about errors to healthcare organizations through data collection systems designed to improve patient safety, and discussing errors with fellow healthcare professionals to promote professional learning and receive emotional support. Communication about errors in these three contexts depends on healthcare professionals who are honest, reflective, compassionate, courageous, accountable, reassuring, and willing to acknowledge and engage their own feelings of sadness, fear, and guilt. Healthcare organizations should promote a systems approach to patient safety and cultivate a culture of transparency and learning in which healthcare professionals are supported as they cope with the distress they experience after an error. Communication about errors should be incorporated into all healthcare practice settings (medical, surgical, in-patient, out-patient), and can be taught to medical students and residents using didactic, role-playing, or simulation methodologies.
与患者和家属就医疗错误进行沟通，通过对话过程，提供信息、承认伤害，并保持信任，展示尊重、同情和承诺，该过程涉及多次沟通。这种沟通需要知识、技能和态度，使医疗保健专业人员能够透明地讨论事实，对所发生的事情负责，并表达遗憾和（酌情）道歉；这些能力还使专业人员能够描述患者的下一步情况，并解释为防止将来在其他人身上发生此类错误而将采取的措施。医疗错误的沟通还包括另外两个方面：通过旨在提高患者安全的数据收集系统向医疗保健组织报告错误信息，以及与其他医疗保健专业人员讨论错误，以促进专业学习和获得情感支持。这三个方面的错误沟通都依赖于诚实、反思、富有同情心、勇敢、有责任心、能使人安心和愿意承认并应对自己的悲伤、恐惧和内疚感的医疗保健专业人员。医疗保健组织应提倡采用系统方法来确保患者安全，并培养一种透明和学习的文化，在这种文化中，医疗保健专业人员在应对错误后所经历的痛苦时会得到支持。应将错误沟通纳入所有医疗保健实践环境（医疗、外科、住院、门诊）中，并可以使用教学、角色扮演或模拟方法向医学生和住院医师传授。
