Tuesday March 18, 2008
Guidelines on disclosing medical mistakes
Citing the belief that patients have a right to be informed of mistakes made in their care and treatment, the Canadian Patient Safety Institute today released comprehensive guidelines for healthcare workers to disclose errors.
You can see the guidelines here:
Previous Comments (6)
Mistakes happen and are likely to get more prevalent in Canadian Hospitals.
With a federal mandate to decrease ER wait times my Health region has responded by rapidly shifting patients to over flow capacity beds, often in hallways with no privacy, and by going beyond established nurse patient ratios they are seeing just how far they can push the limits until nurses quit or go casual due to burn out or something happens to a patient. Remember nurses under this system can not say no to just one more as we are employees and are assigned a work load unlike doctors who are contractors that can refuse, but hey why would you as you get paid by the patient and there is always a nurse who will call if thing go south.
Simple you never get more with less, unless it is mistakes that your looking for.anaonymous, March 20, 2008 4:42 PM
I am so very disappointed in this morning's episode on malpractice that concluded by Dr.Goldman "I don't think doctors feel the heat from malpractice." this is a gross misrepresentation that feeds into "good radio" but is not backed by anything other than rhetoric. Many a physician has suffered immeasurably by both unfounded and founded malpractice suits, destroying many lives, families in the wake. Dr. goldman does not represent any phgysician that I know of when he says that and i feel the public has been done a disservice by his radio show.Dr.Susanne Voetmann, March 24, 2008 3:06 PM
I commend Dr.Goldman, the CBC and all the legal and healthcare professionals that contributed to the program regarding malpractice and disclosure of "adverse events" in our medical arena.
I am a healthcare professional myself and know all too well the "policies and procedures" that we as employess are encouraged to follow to the letter! (sometimes to a fault)
Dr. Voetmann (the prior comment) must remember, when she and her collegues are suffering and struggling emotionally to recover from founded or unfounded malpractice suits, they can at least rest easy with the knowledge that the CMPA and it's Army of medical experts will be there for them from start to finish.
The patients however must rely on their "gut instincts" or maybe the help of a family member who "might" have a shred of medical experience to help them in the sorted, tedious, dead end journey in trying to find out what went wrong, all the while dealing with the physical and emotional repricussions of whatever "adverse event" may (or may not) have occurred.
It's not easy becoming a doctor...it's even harder to become a great doctor.
I always like to think doc's have a sign up in their office "....first, do no harm..."anonymous, March 25, 2008 6:58 PM
Hi Brian, thanks for your honest and enlightening show. One comment: "Adverse Event" does NOT mean mistake. The definition from the guidelines is: "an event which results in unintended harm to the patient and is related to the care and/or services provided to the patient rather than to the patient's underlying medical condition". This includes the known and predictable side-effects of interventions. Eg. if a person has an intracranial bleed from a clot-buster for his heart-attack, this is an unfortunate 'adverse-event' but by no means is it a mistake. This does not lessen the need for disclosure, but it also means there was no mistake or mismanagement of the patient made. I think it's important for your audience to understand this difference.chuck, March 25, 2008 9:22 PM
I cannot thank you enough for providing the link to the Canadian Patient Safety Institute. As a lay person I would not have heard of the CPSI and the Guidelines, had it not been for your information. Now, let's tell patients to practise due diligence, including questioning their health professionals, e.g., asking to see their own charts, asking about adverse effects of certain drugs and combinations thereof, asking how often they have performed a particular procedure,and most definitely, asking about historical outcomes. We must inform both patients and professionals that neglect for any reason is unacceptable; proper research should be performed before prescribing new meds, and both parties should listen carefully to each other. I suggest patients bring notepads and write down what has been discussed. Include the date, situation and outcome. When you get home, place the information in a special file. You may very well need it.
Thanks again for an excellent show.
Falling Out of Bed turns out to Benefit Patient
While recuperating from spinal cord surgery to remove an encapsulated tumor, the lower bed rail was left down by a negligent staff member of the hospital. As part of my recuperation, I had to keep the top half of my bed raised, and over time I would slide down and need to get myself back in place. To do this, I used the lower bed rail to push myself back up the bed.
When I went to do this one evening, the lower bed rail was not there, and I kept sliding, until I was hanging by my neck from the upper bed rail, my bottom just managing to touch the ground.
My roommate who was deaf, did not hear the thump as I hit the ground, but I was discovered hanging there when the nurse made here rounds with a flashlight some 20 minutes later. I complained of neck pain and I wasn't sure if i had had it before.
Anyway in my quest to find the source of the pain, I started trekking from family doctor to dentist, to dental surgeon. Each of these appointments took time to get and by the time i made it to a dental surgeon, he suggested that I have the small lump under my ear looked at by an ENT specialist that I had already seen. Three weeks later, the specialist determined that whatever it was, it had to come out. It was a very fast growing tumour and I was lucky to have it caught so early.
In fact it turned out I was lucky to have fallen out of bed. Several years later, I finally twigged that I had a case of whiplash. Naturally, the hospital was not about to point this out so passed me off to my family doctor, who missed it.