+ The toll of patient safety incidents
- A patient safety incident can have profound consequences for the MRT as well as the patient.1
- Common reactions reported by professionals involved in incidents include distress, self-doubt, confusion, fear, remorse, guilt, feelings of failure and depression, anger, shame and inadequacy that often persist for longer periods2
- Both poor patient outcomes and higher degrees of perceived personal responsibility seem to amplify emotional distress for carers2
- Litigation and complaints impose an additional burden1
- Following an incident, healthcare professionals have been shown to react by sometimes practicing more defensively or by distancing themselves from the sources of potential incidents (restricting scope of practice).3
- Defensive practice can lead to a degradation in the quality of care and a system that is more prone to error2
+ Importance of support for MRTs
- A just and trusting culture, including management support for disclosure and incident reporting, helps provide reassurance that incidents are being handled in the appropriate way.
- Talking and listening to colleagues, including professional reaffirmation and reassurance, is important in dealing with and being able to learn from incidents.1
- Studies have shown that healthcare professionals benefit from the opportunity to discuss patient safety incidents with their peers in both formal and informal settings1
- Concerns about professional credibility and job security may be addressed in this way
- The process of disclosure has been shown to help the healthcare professional recover from the experiences of a patient safety incident.4
- Immediate practical support for MRTs could include education on disclosure of safety incidents, liability and/or associated legislation.1
- In cases where the outcome of the incident is severe, or if the MRT requires assistance (e.g., death of a patient), employee assistance programs or formal psychological counseling are encouraged.1
- Vincent C. Understanding and responding to adverse events. N Engl J Med 2003;348(11):1051-1056.
- Schwappach DLB, Bolluarte DA. The emotional impact of medical error involvement on physicians: a call for leadership and organisational accountability. Swiss Med Wkly 2009;139(1-2):9-15.
- Hofeldt RL. Impact of Adverse Events on Health Care Providers. Presentation. Available at: http://www.mnpatientsafety.org/files/confpdfs/hofeldt-ronald.pdf. Accessed April 4, 2012.
- Canadian Patient Safety Institute, Canadian Disclosure Guidelines: Being open with patients and families 2011: Available at: http://www.patientsafetyinstitute.ca/English/toolsResources/disclosure/Documents/CPSI%20Canadian%20Disclosure%20Guidelines.pdf. Accessed April 4, 2012.