ACOG Committee Opinions Address Disclosing Errors and Managing Fatigue
March 7, 2012 | Strategic Insights for Health System
Improving the disclosure process through education, policies, programmatic training, and accessible resources will enhance patient satisfaction, strengthen the physician-patient relationship, reduce physician stress, and most importantly, promote safe and high-quality healthcare, states a March 2012 committee opinion from the American Congress of Obstetricians and Gynecologists (ACOG). In the committee opinion, ACOG discusses the broad evidence base supporting full disclosure and explores some of the barriers to the process, such as fear of retribution for reporting an adverse event, lack of training, a culture of blame, and fear of lawsuits. To overcome these barriers, ACOG recommends that healthcare facilities establish a nonpunitive, blame-free culture that encourages staff to report adverse events and near misses (close calls) without fear of retaliation. The committee opinion offers general guidelines regarding disclosure conversations with patients, including gathering all of the facts of the error before sharing with the patient, disclosing errors as soon as possible, preserving patient confidentiality, conveying information in terms that the patient can understand, and ensuring that disclosing physicians express appropriate regret for their errors.