Study Says Patients Rarely Know About Medication Errors

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When your organization makes a mistake with a patient’s medication, should you inform that patient about this mistake, even if it isn’t a harmful or life-threatening mistake?

According to an article from Reuters, most hospitals err on the “no” side of this question and do not tell the patients about the mistake.

The researchers behind the study cited in the article believe that this could be for an understandable reason, since “most medication mistakes did not harm patients.”

However, the mistakes that were harmful tended to occur in the ICU, “and ICU patients and families were less likely to be told about errors than patients in other hospital units,” the article says.

Asad Latif, the study’s lead author and an assistant professor at Johns Hopkins University School of Medicine, told Reuters, “For the most part, our findings were in keeping with what the existing literature tells us about the where and how of medication errors in a hospital. The most surprising finding was what we do about them, at least in the immediate time around when they occur.”

The study looked at “a database of about 840,000 voluntarily reported medication errors from 537 U.S. hospitals between 1999 and 2005.” 6.6 percent of these errors came from the ICU. Rarely did an error lead to a patient’s death and rarely did an error do harm to those patients (98 percent of the time the patients were unaffected).

Of the deaths that did occur, 92 were in non-ICU areas, while 18 were in the ICU. Most of the time, the reported errors were ones of omission (“failing to give a patient the medication”), and “harmful errors most often involved devices such as intravenous lines and mistakes in calculating medication dosages.”

Furthermore, the article says, “More than half of the time, no actions were taken after an error. In fact, only a third of the hospital staff who made the reported mistakes were immediately told about their errors.”

And how often was the patient and their family informed of the error? “Barely two percent of the time,” according to Latif.

I’m not going to lie. As a lay person, reading this is a bit discomfiting. Regardless of the reasoning behind not telling the patients, there doesn’t seem to be adequate justification for hiding a mistake from them, especially in an age of transparency.

As commenter Kathy Day writes in the feedback section, “About the only thing good that can be said about medication errors or medical errors of any kind is that they are an opportunity for everyone involved to learn and make improvements…to make sure it doesn’t happen again. Not telling the patient about the error leaves them completely out of the equation. Patients or their chosen advocate can help to stop medication errors, and if there has already been an error, they learn that it is best to never let their guard down. Nondisclosure does nothing at all except perpetuate the problem and keep hospital secrets.”

However, we’re interested in hearing from our readers on this matter. We talk with so many high-quality organizations on a daily basis, encountering medical professionals who are dedicated, innovative, and compassionate, that this study’s results are hard to believe. What could be the reasoning behind not telling a patient about a medication error? Is there a fear of reprisal, even if the mistake doesn’t harm them? Or is there a fear for the hospital or organization’s reputation and standing within the community or system to which they belong?

This article doesn’t give physicians or healthcare organizations a chance to give their side of the story. We’d love for you to take the time and do that here.

-by Pete Fernbaugh

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