Question

Chapter 17 of the course text discusses four barriers to disclosure and responses in health care. Please describe each of them and discuss how healthcare organizations can effectively respond to these barrier challenges.

1. barrier of culture blame and humiliation for error professional arrogance, and provider competitiveness

2. lack of control on providers part to disclose, disagreement bout whether there was an error

3. professional and legal implications

4. uncertainties about how to disclose if an error has occurred.

Answer 1

1. Barrier of culture blame and humiliation for error professional arrogance, and provider competitiveness-

            Though there are several benefits of disclosure, there are barriers to such disclosures. One such main barrier is the barrier of culture blame and humiliation for error. The health care providers usually do not accept the errors and there arises the culture of blame. They do not want to accept their errors and consider themselves as professionals in their fields. This is also called as professional arrogance. Appropriate steps need to be taken by the organizations to control these professionals.

2. Lack of control on providers part to disclose, disagreement about whether there was an error

Once the disclosure is made, the providers lack control over it. This means that after the disclosure is made, the providers lack control over the issue and they need to provide explanation and details for the occurrence of the error which is not accepted by the providers. This is also part of the culture of blame wherein they don’t accept the error and try to blame others. On the other hand, providers lack control of the system of care in order to promote preventive efforts. Hence, they are helpless to address the errors and disclose them in detail. A proper error reporting system should be in use by the health care organizations to address this issue.

3. Professional and legal implications-

The error reporting system has the methodology to penalize those who have caused the error. Thus, this leads to barriers to disclosing the errors. There is always a fear of legal and financial liability for the professionals. This results in loss of reputation, loss of profession and their earned position in the health care industry. The stringent policies maintained by the healthcare organizations act as a disciplinary guide for the health care professionals.

4. Uncertainties about how to disclose if an error has occurred.

There are uncertainties about how to disclose the error because the providers are uncertain which error to disclose. Some health care organizations are willing to disclose all the errors and its outcomes irrespective of the consequences. However, other organizations disclose only the medical error that has led to patient injury. The ethical values need to be communicated effectively by the healthcare organizations to address this barrier.