Patients' idea of med errors affects satisfaction

All of the emphasis on reducing medical errors has not escaped your patients' attention, and they may be defining the term so broadly that they will never be satisfied with your care, according to the results of a recent study from the Joint Commission.

The research suggests that hospital patients define medical errors much more broadly than the traditional clinical definitions of medical errors. The patient definition of medical errors includes communication problems, responsiveness, and falls, according to the study.1 Thomas E. Burroughs, PhD, a researcher with the St. Louis University Center for Outcomes Research in Missouri and lead author of the study, says the findings point out the need for physicians and other health care professionals to clarify what patients mean when they talk about an "error" or "mistake."

The study of more than 1,600 patients at 12 Midwestern hospitals also shows the importance of explaining exactly what is meant by the term "medical error" if patients are to be effectively engaged in programs to prevent them. Burroughs and his colleagues conclude that most patients felt a high level of medical safety, but 39% experienced concern about at least a single type of medical error during their hospitalizations. Certain groups of patients were more likely to be concerned about medical errors, such as middle-aged patients, parents of pediatric patients, and blacks.

In addition, patients who experience longer lengths of stay, more severe illnesses, or were admitted through the emergency department were likely to have more concerns. Patients who received care in small and rural hospitals reported the fewest types of concerns, regardless of the severity of illness. The authors of the study note that programs to educate patients to play a more active role in preventing errors may need to be tailored to effectively address the fears and concerns of each patient.

"The study underscores that patients and clinicians can have different views of the things that constitute a medical error," Burroughs says. "For patients, clear communication and responsiveness are particularly important. If these are lacking, patients may view this as a medical error. It is important that clinicians recognize these differences and the importance of communication and responsiveness."

Burroughs says the research showed a strong link exists between a patient's concerns about medical errors and his or her satisfaction with the entire hospital experience. A single concern was tied to a significantly reduced likelihood of recommending and returning to the hospital for future care. It is important to note that these
are "concerns," not necessarily actual errors.

"For patients, it appears that error-related concerns alone, even if not linked to an actual error, are enough to significantly affect their perceptions of the entire experience, which could alter adherence and willingness to return for care," he says.


1. Burroughs TE. Patients' concerns about medical errors during hospitalization. Jt Comm J Qual Saf 2007; 33:12-16.


For more information on the study regarding medical errors, contact:

  • Thomas E. Burroughs, PhD, St. Louis University Center for Outcomes Research, Salus Center, Second Floor, 3545 Lafayette Ave., St. Louis, MO 63104. Telephone: (314) 977-9300. E-mail: