Patient Preferences in Cases of Inter-system Medical Error Discovery (IMED)

Abstract

Objective: This study analyzes patients' preferences around disclosure in cases of IMED.

Background: Patients prefer that physicians disclose their self-discovered medical errors, and disclosure expectations and practices have changed accordingly. Patient preferences about disclosure when physicians discover another provider's error are unknown.

Methods: We conducted telephone interviews beyond thematic saturation (N = 30) from January to March 2018 with patient volunteers in Michigan. Participants responded to 2 medical error vignettes, the first involving a single physician discovering their own error, and the second involving an IMED scenario. Interviews were conducted concurrently with thematic coding, coded independently by 2 investigators, and discussed until consensus was reached. Analysis proceeded after the inductive and comparative approach of interpretive description.

Results: Patients considered IMED essentially equivalent to self-discovered errors, and strongly preferred disclosure in both scenarios. Patients preferred disclosure for a variety of reasons, most commonly describing an inherent value in knowing about their own health, a belief that physicians should practice honesty and transparency, and a desire to participate in future care in an informed manner. Patients said they would likely take certain actions after disclosure of another physician's error, ranging from confronting the responsible physician to changing providers to pursuing legal action, with the latter being only in cases of irreversible and debilitating errors.

Conclusions: This study explores a new domain within the field of error disclosure, concluding that patients preferred disclosure of errors in cases of IMED. Overall, these findings provide motivation to devise systems-level solutions to enable and facilitate IMED disclosure.