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Qual Saf Health Care. 2006 April; 15(2): 136–141.
doi: 10.1136/qshc.2005.015602.
PMCID: PMC2464838
Patient assessments of a hypothetical medical error: effects of health outcome, disclosure, and staff responsiveness
A Cleopas, A Villaveces, A Charvet, P A Bovier, V Kolly, and T V Perneger
A Cleopas, A Villaveces, V Kolly, T V Perneger, Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland
P A Bovier, Department of Community Medicine, University Hospitals of Geneva, Geneva, Switzerland
T V Perneger, Institute of Social and Preventive Medicine, Faculty of Medicine, University of Geneva, Switzerland
Correspondence to: Dr T V Perneger
Quality of Care Service, University Hospitals of Geneva, 1211 Geneva 14, Switzerland; thomas.perneger@hcuge.ch
†Deceased.
Accepted January 24, 2006.
Abstract
Objective
To assess whether patients' perceptions of a hypothetical medical error are influenced by staff responsiveness, disclosure of error, and health consequences of the error.
Design
Hypothetical scenario describing a medication error submitted by mail. Three factors were manipulated at random: rapid v slow staff responsiveness to error; disclosure v non‐disclosure of the error; and occurrence of serious v minor health consequences.
Participants
Patients discharged from hospital.
Measures
Assessment of care described in the scenario as bad or very bad, rating of care as unsafe, and intent to not recommend the hospital.
Results
Of 1274 participants who evaluated the scenario, 71.4% rated health care as bad or very bad, 60.2% rated healthcare conditions as unsafe, and 25.5% stated that they would not recommend the hospital. Rating health care as bad or very bad was associated with slow reaction to error (odds ratio (OR) 2.8, 95% CI 2.1 to 3.6), non‐disclosure of error (OR 2.0, 95% CI 1.5 to 2.6), and serious health consequences (OR 3.4, 95% CI 2.6 to 4.5). Similar associations were observed for rating healthcare conditions as unsafe and the intent to not recommend the hospital. Younger patients were more sensitive to non‐disclosure than older patients.
Conclusions
Former patients view medical errors less favorably when hospital staff react slowly, when the error is not disclosed to the patient, and when the patient suffers serious health consequences.
Keywords: patient perceptions, medical error, patient safety