Medical error transparency is the missing factor in healthcare's quest for quality, according to a New England Journal of Medicine Perspective article from Boston-based Brigham & Women's Hospital's Associate Chief Quality officer Allen Kachalia, MD.
Dr. Kachalia said while public reporting has become commonplace, disclosure of medical errors has proven more difficult to achieve, given that that more hospitals take a punitive approach to error reporting than not, and given that clinicians report anxieties about error reporting.
Dr. Kachalia listed several steps institutions may take to move towards transparent error reporting.
1. Embrace a just culture. Don't let clinicians worry about their jobs over doing the ethical thing. Hold clinicians accountable for willful violation of protocols, not human error.
2. Address clinician and patient concerns before releasing error information. This will give all parties an opportunity to air anxieties about making information public.
3. Reduce clinician concerns over litigation and liability-related reporting requirements. According to Dr. Kachalia, institutions can prevent activation of physician error-reporting requirements by accepting sole liability for adverse systemic events, though this somewhat undermines the purpose of the National Practitioner Data Bank.
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