April 2-4, 2020 • Hyatt Regency • Lexington, KY
Intersectionality and Interdisciplinarity in Health Communication Research
Abstract: Perceptions of Medical Error Risk and Severity on Disclosure Preferences
◆ Heather J. Carmack, University of Alabama
Rationale: Medical errors account for more deaths per year than car accidents, HIV/AIDS, and breast cancer combined, making medical errors the third leading cause of death in the US. Medical errors are understood by providers and administration as an inevitable part of the practice of healthcare. Most communication research on medical errors focuses on provider perceptions of errors and their involvement in the apology and disclosure process. But what is the general public’s perceptions of medical error risk? Does this risk impact their disclosure preferences? This study fills the communication discipline’s gap in research by examining lay perceptions of medical risk and disclosure preferences.
Methods: Participants (N =276) completed an online survey about medical error risk perceptions and disclosure preferences. Participants were primarily women (80.4 %) and Caucasian (89.5%). Average participant age was 31.24 (range 18-72). 17% stated they had been the victim of a medical error and 47.1% said they knew a friend or family member who had experienced a medical error. Participants were also asked to rate the level of perceived severity of 24 common medical errors. These rankings were used to categorize medical errors into perceived low, moderate, and high severity.
Results: Participants’ perceptions of medical error risk belief was significantly correlated with medical error severity belief and approaching significance with medical error susceptibility belief, suggesting that as perceived medical error severity belief increases, medical error risk belief increases. Although the correlation between susceptibility and risk was not significant, this may be because medical error susceptibility belief (M = 2.53) was much lower than severity belief (M = 3.04) and risk belief (M = 3.46).
Participants’ perceived medical error severity was correlated with their disclosure preferences. Participants believed high severity medical errors should always be disclosed, significantly correlated with errors resulting in severe, moderate, and minor harm to the patient. High severity also correlated with near misses (errors that are caught before they result in patient harm). Patients preferred the disclosure of moderate severity errors only when they results in minor harm. Interestingly, 9.8% of participants indicated that they preferred not be informed about any medical error. Medical error severity was also significantly correlated with disclosure personnel preferences. Participants believed the medical error provider who made the error should disclose to patients in cases of moderate and high severity errors. The provider’s supervisor, medical director, or facility CEO could disclose low, moderate, and high severity errors to patients.
Implications: Although the statistics surrounding medical errors are concerning, results suggest that the participants did not see themselves particularly vulnerable to medical errors. Surprisingly, participants also did not support universal disclosure of medical errors. Instead, the level of severity of the error influenced the disclosure of the error, regardless of the level of harm caused by the error. Participants are also not as interested in the disclosure of minor errors, such as forgetting to put bed rails down. Additionally, the results raise questions about facility administrative involvement in disclosure and who takes responsibility for disclosing medical errors.