Browsing by Subject "Medical errors"

Now showing 1 - 2 of 2
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    Asynchronous Conferencing Through a Secure Messaging Application Increases Reporting of Medical Errors in a Mature Trauma Center
    (Sage, 2023) Lee, Joy L.; Isenberg, Scott; Adams, Georgann; Thurston, Maria; Hammer, Peter M.; Mohanty, Sanjay K.; Jenkins, Peter C.; Surgery, School of Medicine
    Background: Medical errors occur frequently, yet they are often under-reported and strategies to increase the reporting of medical errors are lacking. In this work, we detail how a level 1 trauma center used a secure messaging application to track medical errors and enhance its quality improvement initiatives. Methods: We describe the formulation, implementation, evolution, and evaluation of a chatroom integrated into a secure texting system to identify performance improvement and patient safety (PIPS) concerns. For evaluation, we used descriptive statistics to examine PIPS reporting by the reporting method over time, the incidence of mortality and unplanned ICU readmissions tracked in the hospital trauma registry over the same, and time-to-loop closure over the study period to quantify the impact of the processes instituted by the PIPS team. We also categorized themes of reported events. Results: With the implementation of a PIPS chatroom, the number of events reported each month increased and texting became the predominant way for users to report trauma PIPS events. This increase in PIPS reporting did not appear to be accompanied by an increase in mortality and unplanned ICU readmissions. The PIPS team also improved the tracking and timely resolution of PIPS events and observed a decrease in time-to-loop closure with the implementation of the PIPS chatroom. Conclusions: The adoption of clinical texting as a way to report PIPS events was associated with increased reporting of such events and more timely resolution of concerns regarding patient safety and healthcare quality.
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    “If your feelings were hurt, I’m sorry…”: How Third-Year Medical Students Observe, Learn From, and Engage in Apologies
    (Springer, 2021) Fischer, Ian C.; Frankel, Richard M.; Psychology, School of Science
    Background: Apologies may play a significant role in medical care, especially in the context of patient safety, medical error disclosure, and malpractice. Studies have shown that when state laws, institutional policies, and individual skills align-including the ability to offer a sincere apology-patients and families benefit. However, little is known about how, and under what conditions, physicians offer apologies in day-to-day care. Even less is known about what medical students learn about apologies from observing their superiors in these settings. Objective: Characterize third-year medical students' experiences of observing and engaging in apologies. Design: Qualitative descriptive analysis of student professionalism narratives. Participants: Third-year medical students at Indiana University School of Medicine. Approach: A search of 7,384 unique narratives yielded 238 with apologies. A rubric based on four key elements of genuine apologies ((1) acknowledgement, (2) explanation, (3) regret/remorse, and (4) reparation) was used to classify the kind of apology offered. Apology completeness, impact, and timing were also coded. Key results: Seventeen percent of all apologies were complete (i.e., contained all four elements). Over 40% were coded as incomplete or "non-apology" apologies (i.e., those with only the first two elements). A significant relationship between apology completeness and positive student experience was found. Most apologies were offered by the attending physician or resident to patients and family members. Students were generally positive about their experiences, but one in five were coded as negative. Some students were distressed enough to offer apologies on behalf of the faculty. Apology timing did not make a significant difference in terms of student experience. Conclusions: Few education programs target apologies in the context of routine practice. With little formal instruction, students may rely on adopting what their seniors do. Faculty have an important role to play in modeling the apology process when harms-both great and small-occur.