The findings of a study published on June 19, 2015 in the journal BMJ Quality & Safety involving 450 respondents to an online survey of patients and families regarding adverse medical and surgical events, who also provided written narratives in addition to filling out the quantitative survey, “highlights the concerns of patients and families who have experienced adverse events. They perceived a lack of accountability on the part of both caregivers and health systems, and repeatedly commented on poor and at times disrespectful communication both before and after the adverse event. Many described profound suffering, and as a consequence of how they were treated, a loss of trust in their health delivery system and providers. Respondents made a number of suggestions for improvement, and emphasised [sic] the importance of patients and families being actively involved in decisions about their care.”
Who Were The Respondents To The Survey?
The study’s authors created a nationwide voluntary survey to investigate the perspective of patients and patient families who had experienced adverse medical and surgical events. The survey took place between January 2010 and November 2013. There were 696 respondents to the survey, of which 681 were from the United States and all U.S. states were represented, except for North Dakota.
The 450 participants in the survey who also provided written narratives (which ranged from a few words to several pages) were nearly equally divided between patients and family members. A majority of the family members who were respondents stated that their family member had died.
The patients who were respondents ranged from age 2 to 90, with the mean-age being 54.9. More females reported adverse events (394) than males (279). The number of respondents who were patients was 346 and the number of family members who were respondents was 332. The rest of the respondents were friends (10), healthcare professionals (6), a patient advocate, and a pastor.
Categories Of Medical Errors
The researchers found that the leading category of medical errors that was reported by the respondents was failure in diagnosis and treatment (the leading event in this category was a delay in diagnosis and treatment, followed by misdiagnosis and failure to rescue a patient whose clinical condition was worsening).
The next most common category of medical errors was surgical or procedural complications (wrong site surgery represented 4.3% of the medical errors in this category and foreign objects left in the patient represented 3.6% of the medical errors in this category).
The third most common category of medical errors was hospital-associated infections (sepsis was the most common followed by postoperative infections, c. diff intestinal infections, and urinary tract infections).
The fourth most common category of medical errors was medication errors (12.8% reported receiving medications to which they had suffered an allergic reaction in the past).
Feelings Of Lack Of Accountability And Abandonment
Significantly, 90% of the quantitative survey responses expressed concern about a lack of provider accountability, indicating their belief that their heath system and their providers often failed to appropriately respond to their suffering (in 48% of the responses, the provider had insisted that care had been appropriate but the family believed otherwise; in 47% of the responses, the provider denied responsibility; in 40% of the responses, the family complained that the investigation was secretive and there was an unwillingness to include the family in the investigation; and, one-third of the respondents stated that the providers who initially cared for the patient refused further communication after the adverse event).
In discussing their analysis of the survey’s narratives, the study’s authors stated, “Adverse events were often accompanied by a sense that providers and health systems did not feel responsible or accountable for the harm that patients and family experienced. Second, patients and families felt that providers failed to effectively communicate with them both before and after the adverse event, and too often when providers did communicate the interactions were disrespectful. Third, those who had suffered medical harm emphasised [sic] the profound emotional, physical and financial impact of these events. In the hopes of preventing similar adverse events from impacting future patients, they offered constructive suggestions for preventing future errors.”
Source “A patient-initiated voluntary online survey of adverse medical events: the perspective of 696 injured patients and families”
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