Pediatricians struggle with error disclosure

Almost 100% of pediatricians in a recent survey said serious medical errors should be disclosed to patient's families, with almost all saying making that admission to parents would be difficult. Most pediatricians support both reporting medical errors to hospitals and disclosing them to patients' families, but say they believe formal error-reporting systems are inadequate, according to results published in the February issue of Archives of Pediatrics & Adolescent Medicine (2007;161:179-185).

The survey attempted to shed light on why, with physicians encouraged to openly communicate errors to improve patient safety, many errors still remain unreported to hospitals and patients. The authors speculate reasons may include a medical culture of autonomy and individual accountability, the threat of legal action, and fear of damage to professional reputation.

The survey asked slightly more than 550 pediatricians and pediatric residents about their experiences and attitudes toward disclosure. Most reported they had been involved in at least one error: 39% a serious error, 72% a minor error, and 61% a near miss. Slightly more than 90% said they use a formal error-reporting system; three-quarters said they informally report by telling supervisors, senior staff, or colleagues. Only slightly more than one-third had ever disclosed a serious error with a patient's family.