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Pediatricians must disclose adverse events and medical errors to children and their families, according to an updated policy statement<\/a> from the American Academy of Pediatrics.<\/p>\n The new statement expands upon a 2016 version that said health systems need to create a work culture in which clinicians feel they can report incidents to their employers \u2014 as well as patients and their families \u2014 without fear of repercussions. The updated statement says health systems should make disclosure and reporting an automatic and embedded practice, even when not required by law.<\/p>\n \u201cProviders are committed to the principle of transparency and openness but struggle turning that commitment into practice,\u201d said Thomas Gallagher, MD, a professor of medicine and associate chair of Patient Care Quality, Safety and Value at University of Washington Medicine in Seattle, who was not involved with the policy statement. \u201cOur human nature when something goes wrong is to hide it and hope it just blows over.\u201d<\/p>\n Most pediatric care occurs in outpatient settings, and most errors are related to medications, vaccines, diagnoses, and coordination of care transitions, the statement said. Far less data exist on events that occur in pediatric care compared with adults, despite similar requirements for both groups of patients. A 2023 study<\/a> found only 3.1% of reports filed with the US Food and Drug Administration\u2019s Adverse Event Reporting System<\/a>, a voluntary reporting database, involved children.<\/p>\n Improving patient safety starts with continuing to shift the healthcare industry\u2019s culture around reporting errors, according to the AAP\u2019s statement.<\/p>\n \u201cIncreasingly, the culture of pediatrics, and healthcare in general, is to promptly disclose to patients and families after an [adverse event] has taken place,\u201d the statement said. \u201cShame, fear of professional and legal repercussions, and lack of training remain barriers to disclosure.\u201d<\/p>\n The AAP outlines how clinicians and healthcare administrators can make reporting and disclosure an automatic part of practice. These steps include:<\/p>\n Medical schools and training staff should develop programs that teach healthcare workers how to talk to families and pediatric patients when medical errors occur.<\/p>\n \u201cThis needs to become a routine part of medical training so we learn how to prevent them from happening,\u201d said Danielle Thurtle, MD, CPPS, a pediatrician and patient safety officer with Sanford Health in Bismarck, North Dakota, and an author of the policy statement.<\/p>\n Laura Sigman, MD, an assistant professor of pediatrics at Johns Hopkins Children\u2019s Center in Baltimore, who helped write the policy statement, said she has already noticed a difference among newer clinicians who received education on the importance of reporting errors during medical school.<\/p>\n \u201cWe see trainees now that never question that they would disclose a medical error, and there is really an opportunity to tailor our education to make sure people have training on the protocol,\u201d Sigman said.<\/p>\n Children are three times more likely than adults to experience an adverse event related to medication, according to the Joint Commission, a nonprofit that certifies and accredits healthcare organizations.<\/a> And medical errors in pediatrics are often underreported and disjointly collected<\/a>, particularly in outpatient care.<\/p>\n Newer research<\/a> on which pediatric patients may be most susceptible to errors prompted the AAP to add direction on identifying high-risk patients to its guidelines.<\/p>\n Children and teens from low-income families, who have special health needs and those who speak English as a second language, are at a greater risk for medical errors, according to the AAP.<\/p>\n \u201cKids who are nonverbal or cannot speak up for themselves have less of an ability to communicate what they are experiencing, so we think adverse events related to medication are much higher than we think in outpatient settings,\u201d Sigman said.<\/p>\n Part of the problem of underreporting and disclosure is a patchwork of standards from states and employers, said Ulfat Shaikh, MD, MPH, a professor of pediatrics and medical director for Healthcare Quality at the University of California Davis Health, Sacramento.<\/p>\n \u201cThere is quite a bit of variation,\u201d Shaikh said.<\/p>\n Laws regarding what events health organizations must report to outside entities, such as federal databases<\/a> or nonprofit accreditation organizations<\/a>, change state by state, as do laws that protect clinicians from legal ramifications after reporting. Each health system also has its own set of standards its employees are expected to follow.<\/p>\n Pediatric providers \u201cabsolutely need to have a centralized reporting system,\u201d Thurtle said.<\/p>\nBusiness News Patient Safety Starts With Provider Culture<\/strong><\/h2>\n
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Business News Caring for High-Risk Communities<\/strong><\/h2>\n
Business News Disjointed Practices<\/strong><\/h2>\n