Disclosure of Medical Errors

Introduction to Disclosure Guidelines

The American College of Emergency Physicians recommends that emergency physicians disclose significant medical errors to patients or their representatives in a timely fashion, in accordance with hospital policy 1
The Association of Anaesthetists of Great Britain and Ireland states that any incident causing patient harm must be disclosed to the patient or their next of kin in accordance with local policy 2, 3

Patients and families want an honest explanation about what happened, a sincere apology, and information about what will be done to prevent recurrence when a medical error occurs 4, 5, 6

The disclosure should include a timely explanation of the facts, acknowledgment of harm, expression of regret and apology, immediate management plan, and prevention measures 7
Patients should be informed about what is being done to monitor and treat them, as well as what will be done to prevent similar errors in the future 4, 5, 6

Healthcare organizations should have established policies and procedures for identifying and responding to medical errors, provide support systems for healthcare workers, and implement continuous quality improvement systems 1
Institutions should report incidents to both local and national incident reporting systems 2, 3
Poor communication and lack of transparency are primary drivers that cause patients to file lawsuits, and honest disclosure may reduce legal risk 1

Assess whether the hidden error is causing ongoing harm to the patient and take immediate steps to mitigate any continuing risk, as recommended by the American Academy of Pediatrics 8
File a report with your institution's patient safety or quality improvement system immediately, as advised by the American Academy of Pediatrics 8

Approach hospital leadership, risk management, or your patient safety officer if the provider refuses to disclose, as suggested by the American Academy of Pediatrics 8
Most institutions now support disclosure and have policies requiring it—risk managers and hospital attorneys typically support appropriate disclosure efforts, according to the American Academy of Pediatrics 9

Remaining silent makes you complicit in the concealment and violates your professional duty to the patient, as stated by the American Academy of Pediatrics 8

Push for educational interventions on disclosure, transparency, and coping with medical errors integrated into all levels of training, as recommended by the American Academy of Pediatrics 9
Support implementation of continuous quality improvement systems that learn from errors rather than punish individuals, as advised by the American Academy of Pediatrics 8