Case Study: Disclosure of Errors Should Include Conversations With Patient/Families
The case study, which was published in the Joint Commission Journal of Quality and Patient Safety, involved a man diagnosed with multiple myeloma in 2006. He was admitted to the hospital after an orthopedic surgery in January 2009 and died from a drug overdose in February 2009.
Disclosure and quality improvement efforts following the death revealed the event involved more than the adverse drug event.
"You've got a greater problem than a drug error…you've got a massive, big communication problem here," the patient's wife said to a hospital employee. Ongoing communications revealed communication failures and inappropriate behaviors by staff. The researchers concluded meaningful conversations with patients and families following an adverse event could reveal more information than clinicians could discover on their own.
More Articles on Patient Safety:
© Copyright ASC COMMUNICATIONS 2015. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.
New From Becker's Infection Control & Clinical Quality
ASC QI project success: The 4 'E's that drive process standardizationRead Now
- 18 statistics on podiatry revenue per case at ASCs
- Changing Perspectives: One Gatronenterologist's Switch to a Different Brand of Endoscope
- 5 fresh ideas for differentiating your ASC
- 5 recent ASC industry acquisitions
- Physician employment vs. private practice: 14 statistics on pay, satisfaction & more