SA doctors say admitting errors without fear of blame is key to improving patient safety — survey

Nine in ten SA doctors believe healthcare professionals must be able to admit errors, apologise and learn from mistakes without fear of blame, regulatory action or criminal charges in the event of an adverse incident with a patient.

This is according to a survey of 590 doctors conducted by the Medical Protection Society (MPS), which represents 30,000 healthcare professionals in SA.

On Wednesday the society said the survey results bring into sharp focus the need for government to aid a shift to a more open and learning culture in healthcare in which healthcare professionals are supported to discuss and learn from mistakes, and patients are subsequently better protected and better informed.

The organisation said fear of blame, regulatory action or even criminal charges after an adverse incident are a barrier to open disclosure “which must be broken down”.

Dr Graham Howarth, head of MPS medical services Africa, said: “Doctors want to do their very best for patients, but medicine is not an exact science.

“Day in and day out doctors make complex decisions, often in fast moving or pressured circumstances. This means complications and errors can sometimes arise.

“If an error does occur, the practice of open disclosure should mean the patient or their family is told, usually by the treating clinician, and receives a sincere apology and full explanation. This process also enables lessons to be learnt to avoid a reoccurrence.

“Additionally, patients are better informed about their care.

“A culture of fear and blame across the healthcare community is, however, a barrier to open disclosure and to a more open and learning environment being embraced.

“If we are to make continuous improvements to patient safety, it is a barrier that must be broken down.

“These survey results show the real strength of feeling about this issue among healthcare professionals.”

Earlier this year, when SA was battling its second wave of Covid-19 infections, the body urged government to introduce Covid-19 disaster legislation to protect healthcare professionals from legal challenges relating to clinical resourcing decisions they might have to make.

Doctors admitted at the time they felt vulnerable to the risk of prosecution if they had to make life-and-death decisions in the face of limited resources during the pandemic.

Howarth said the body was playing a role in helping to “create an open  learning culture in healthcare”.

“Our risk-prevention programme equips members with resources and training to combat the common causes of complaints and claims, including through improved communication.”

The society also advises members “they should be open and honest with patients, that it is often appropriate to communicate regret and empathy after an adverse outcome, and that doing so is not necessarily an admission of liability”.

“MPS is calling on healthcare leaders, hospitals, government and individual clinicians to take active steps to further aid a shift to a culture of openness and learning in which healthcare professionals feel able to apologise, discuss and learn from mistakes without fear of personal recrimination.

“This would ultimately help to prevent errors from reoccurring, improve patient safety in the future, and the increase in transparency may even help to reduce the number of claims and complaints brought against healthcare professionals when something goes wrong.”

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