Error Disclosure Guidance

The American College of Physicians and American Society of Internal Medicine suggests disclosing if it is material to the patient s weU-being. The AMA advises error disclosure whenever major medical complications occur. The Joint Commission criterion is for any unanticipated outcome. The NPSF bases the disclosure threshold on any injury occurrence. Use a predetermined error threshold. 

Disclosure enhances learning for the clinician and institution. Disclosure enables the patient to obtain appropriate treatment/understanding. Disclosing errors and harm does not result in increased litigation. 

The risk of litigation increases when patients or families sense deception. Some clinicians believe that medical errors or unanticipated outcomes can appear as a negligent disclosure of error or the error it could create liability risks (Table 13.7). 

Honors a patient s wish regarding end of life issues Helps avoidance of discomfort with the preservation of individual dignity Provides for effective pain relief and appropriate emotional support Prevents inappropriate intrusive medical assessments or interventions Permits family and significant personal support including spiritual care Details procedures for palliative medicine or hospice consultation Informs staff about decisions regarding the donation of organs and tissues 

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