Article Text

Support for healthcare workers and patients after medical error through mutual healing: another step towards patient safety
  1. Diane Louise Aubin1,
  2. Allison Soprovich1,
  3. Fabiola Diaz Carvallo1,
  4. Deborah Prowse2,
  5. Dean Eurich1
  1. 1University of Alberta School of Public Health, Edmonton, Alberta, Canada
  2. 2Patients for Patient Safety Canada, Canadian Patient Safety Institute, Edmonton, Alberta, Canada
  1. Correspondence to Dr Diane Louise Aubin; dianaubin{at}gmail.com

Abstract

Background Medical errors, especially those resulting in patient harm, have a negative psychological impact on patients and healthcare workers (HCWs). Healing may be promoted if both parties are able to work together and explore the effect and outcome of the event from each of their perspectives. There is little existing research in this area, even though this has the potential to improve patient safety and wellness for both HCWs and patients.

Methods Using a patient-oriented research approach with constructive grounded theory methodology, we examined the potential for patients and HCWs to heal together after harm from a medical error. Individual interviews were conducted and transcribed verbatim. We conducted concurrent data collection and analysis according to grounded theory principles. With our findings, we created a framework and visual breakdown of the communication process between patients and HCWs.

Results Our findings suggest that, after a medical error causing harm, both patients and HCWs have feelings of empathy and respect towards each other that often goes unrecognised. Barriers to communication for patients were related to their perception that HCWs did not care about them, showed no remorse or did not admit to the error. For HCWs, communication barriers were related to feelings of blame or shame, and fear of professional and legal consequences. Patients reported needing open and transparent communications to help them heal, and HCWs required leadership and peer support, including training and space to talk about the event(s).

Discussion Our resulting framework suggests that if there was an opportunity for an open and purposeful conversation early or before increased emotional suffering, there might be an opportunity to bridge the barriers, and help patients and HCWs heal together. This, in turn, contributes to improved health quality and patient safety.

  • communication
  • patient safety
  • medical error, measurement/epidemiology
  • human error
  • patient participation

Data availability statement

Data are available upon reasonable request. Please contact main author to request further data.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Data availability statement

Data are available upon reasonable request. Please contact main author to request further data.

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Footnotes

  • Contributors DLA, DP and DE conceived this study and obtained funding. FDC developed recruitment materials and coordinated the recruitment of participants. AS performed the interviews and assisted with data collection and preliminary concurrent analysis. FDC and DLA reviewed the transcripts and completed the data analysis and along with DE, collaborated towards drafting the theoretical framework. All authors contributed to finalising the theoretical framework. AS and DLA drafted the manuscript. All authors read and approved the final manuscript. DA accepts full responsbility and is the guarantor of this work.

  • Funding Canadian Patient Safety Institute (now Healthcare Excellence Canada).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.