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Prevention & Disclosure of Medical Error

Prevention & Disclosure of Medical Error. Dr. Ramadan Ibrahim Director Health Regulation Department Dubai Health Authority. Prevention & Disclosure of Medical Error. Dr. Layla Al- Marzouqi Head of Clinical Governance Health Regulation Department Dubai Health Authority.

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Prevention & Disclosure of Medical Error

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  1. Prevention & Disclosureof Medical Error Dr. Ramadan Ibrahim Director Health Regulation Department Dubai Health Authority

  2. Prevention & Disclosure of Medical Error Dr. Layla Al-Marzouqi Head of Clinical Governance Health Regulation Department Dubai Health Authority

  3. Medical Liability Law - 2008 .

  4. Medical Malpractice

  5. Medical Complaint Expressions of dissatisfaction or concerns about a health care service made by consumers. .

  6. 44,000-98,000 preventable deaths each year in U.S. hospitals. This is the equivalent of losing a jumbo jet airliner full of 122-270 passengers / day.[4 ][5][6] medication errors : most common medical mistakes, 1.5 million people /yr. 7,000 people were estimated to die /yr from medication errors. .

  7. .

  8. Medical errors are associated with: • Inexperienced physicians & nurses • New procedures • Extremes of age • Complex & urgent care • Poor communication • Improper documentation • Inadequate nurse-to-patient ratios • Similarly named medications .

  9. Miscommunication Failure to convey relevant medical information to key players in medical team & to patient/family Affect patient safety & quality health care Lower compliance Over investigation Reduce patient satisfaction .

  10. Communication is the best Defense Against Medical Malpractice .

  11. Researchers at State University of NY reported that claims related to communication failure increased from $21.7 million in 1991 to $91 million in 2010. .

  12. Reasons for miscommunication Time issue for physicians Doctor manages a very high volume Patients referred to many specialists before a diagnosis is made Educational disparity between doctors & patients Doctor shopping Communication breakdowns between changing shifts .

  13. Do not expect patients to have a prior understanding of the biology and treatment of medical condition Being positive and supportive is one thing, but manage expectations of each patient .

  14. Best defense any doctor can have is excellent communication skills All medical professionals should develop a habit of writing down what has been communicated to patient.  So if there is a lawsuit, documentation can be provided Informed consent .

  15. Disclosure of Medical error .

  16. have any of you been personally involved in a near miss? a minor error? the disclosure of the error to a patient?

  17. Reasons for not disclosing error:I don’t want to talk about itEmbarrassingOnce you say sorryMedical lawyer

  18. Medical error is not preventable but is it reducible Patient disclosure is important in the medical error process .

  19. Medicine differs from before Now a days: Internet Question Take part in treatment Deeply human connection relationship

  20. Medical injury is different from other injuries in two ways

  21. Disclosure does not always protect the physician from legal law suitshelp in starting grievance for doctors/ patients

  22. “How am I going todisclose an error in a way that maintains a patient’s trust”?

  23. WhoWhenWhereHow No ideal way/standard

  24. Disclosure skills. Openness has potential to heal not to harm Open honest compassionate conversation

  25. Fundamental measures for disclosure: Apology Explanation: what happened/ effect Assurance : analysis/learn Follow up : what has been done

  26. Disclosing :A soon as possibleAsk patients if they would to have familysecond person in the meeting introduction

  27. Communication speech: slowly, softly, simple, pause frequently, give warning Listen without interruption Sitting Eye contact/ body language

  28. What informationDetailed information about the eventHow their health will be affectedWhy?Problem correction and avoidance How will it prevented in futureOffer supportApology

  29. “I am sorry for what happened to you” whether it was an adverse event due to an error“I am sorry for what I did to you” when adverse event was caused by an error or system failure.

  30. Follow uprecord details & minute it

  31. Don’t BlameExpress causationRespond anger with angerPanic if malpractice suit is threatenedInform about litigation opportunity

  32. Use of rationalization to cover up medical errors "Why disclose the error? The patient was going to die anyway.« "Telling the family about the error will only make them feel worse.« "Well, we did our best. These things happen.« It was the patient's fault. If he wasn't so (obese, sick, etc.), this error wouldn't have caused so much harm." .

  33. Thank You .

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