Correspondence
Understanding and Responding to Adverse Events
N Engl J Med 2003; 348:2580June 19, 2003
- Article
To the Editor:
Vincent's thoughtful discussion of adverse events and our response to them (March 13 issue)1 should be mandatory reading for all residents, attending physicians, and dentists. He correctly suggests that the academic health care culture often views mistakes as lapses of character. In such an environment, constructive and empathetic responses characterized by clarity, candor, and compassion may be replaced by self-protective, evasive, or defensive behavior. Those of us who are clinical mentors must create an environment that encourages clinicians to view mistakes as opportunities to improve patient outcomes through thoughtful analysis, while sensitizing residents to the consequences of adverse outcomes for our patients' lives. To this end, we have initiated a program in which patients who have had serious adverse outcomes discuss the consequences of their problem with residents and attending faculty members. This program has been well received by clinicians and patients alike. These sessions often lead to questions about the nature of informed consent as it relates to the probability of adverse outcomes and reinforces the importance of concepts such as the “number needed to harm.”2
2 ReferencesMark V. Thomas, D.M.D.
University of Kentucky College of Dentistry, Lexington, KY 40536-0297
mvthom0@uky.edu 1
Vincent C . Understanding and responding to adverse events. N Engl J Med 2003;348:1051-1056
Full Text | Web of Science | Medline2
Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-based medicine: how to practice and teach EBM. Edinburgh, Scotland: Churchill Livingstone, 2000.
