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Disclosure of Medical Error to Parents and Paediatric Patients
  1. Anne G Matlow*,
  2. Leslie Moody,
  3. jeremy Friedman,
  4. Ronald Laxer,
  5. Polly Stevens,
  6. Cristina Goia
  1. 1 Hospital for Sick Children, Canada
  1. Correspondence to: Anne Matlow, Infection Prevention & Control Programme, The Hospital for Sick Children, Physician Liaison, Patient Safety, 555 University Avenue, Toronto, ON M5G 1X8, Canada; anne.matlow{at}sickkids.ca

Abstract

Objective: To describe parents’ attitudes toward medical error disclosure.

Design: Prospective survey.

Setting: Hospital for Sick Children, Toronto Canada.

Patients: Parents of inpatients and outpatients.

Interventions: Anonymous questionnaire for demographic characteristics, and clinical vignette to identify thresholds for disclosure of medical error.

Main outcome measures: Thresholds for parent and patient disclosure, and associated factors.

Results: 99% of 431 parents (181 inpatients, 250 outpatients), wanted to be informed if there was potential or actual harm versus 77% if not (p<0.0001). Most (71%) wanted their child informed if there was potential or actual harm versus 41% if not (p<0.0001).

Parents’ age, education, religion, experience with error and child’s age did not affect preference for disclosure to themselves. Asia-born parents (p=0.014; OR 2.4, 95% CI 1.2, 4.9), parents of inpatients (p=0.03, OR 1.65, 95%CI 1.04, 2.62), and those administered the survey with increasing severity of harm had a lower disclosure threshold (p<0.0001, OR 2.46; 95% CI 1.58,3.83).

Asian-born parents (p <0.0001, OR 5.3, 95% CI 2.7, 10.6), older child (<6 yrs vs >10 yrs p < 0.0001, OR 2.74, 95% CI 1.73, 4.33), previous experience with error (p =0.05; OR 1.5, 95% CI 1, 2.2), and survey administration with increasing harm (p=0.04, OR 1.46; 95% CI 1.01, 2.10) predicted a lower threshold for informing the child.

Conclusions: Most parents want to be informed of medical error whether harm was caused or not, and want their child informed only if potential or actual harm. Parental country of birth, previous experience with error, and age of the child are potential factors that may influence the parents’ desire for disclosure to their child.

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