Damian Holliman1, Mark Bernstein. 1. Division of Neurosurgery, University Health Network, Toronto Western Hospital, University of Toronto, Ontario, Canada. d.holliman@doctors.org.uk
Abstract
INTRODUCTION: Medical error can result in significant morbidity and even mortality. Public and media attention remains focussed on its incidence and causes. Appreciation of patient perception of medical error in the neurosurgical setting is limited. This study investigated patients' perceptions of potential medical error during craniotomy for brain tumour and whether this influenced their decision to consent. MATERIALS AND METHODS: This study utilised qualitative research methodology. Thirty-five patients who had undergone craniotomy for brain tumour were interviewed using a semi-structured questionnaire. Interviews were transcribed and subjected to thematic analysis. RESULTS: Analysis revealed seven overarching themes: (i) views on what constituted medical error were well formed; (ii) to err is human; (iii) protocols exist to prevent error; (iv) trust in one's surgeon is important; (v) patients' belief that they can influence the likelihood of error was variable; (vi) concern with treating the disease trumps worry over possible errors; and (vii) the usefulness of discussing potential error was variable. CONCLUSIONS: Patients had a good understanding of medical error and it's potential causes. The usefulness of pre-operative, pre-consent discussion of error was varied. It may empower clinicians and patients to talk about such issues, though this should avoid exacerbating a patient's anxiety.
INTRODUCTION: Medical error can result in significant morbidity and even mortality. Public and media attention remains focussed on its incidence and causes. Appreciation of patient perception of medical error in the neurosurgical setting is limited. This study investigated patients' perceptions of potential medical error during craniotomy for brain tumour and whether this influenced their decision to consent. MATERIALS AND METHODS: This study utilised qualitative research methodology. Thirty-five patients who had undergone craniotomy for brain tumour were interviewed using a semi-structured questionnaire. Interviews were transcribed and subjected to thematic analysis. RESULTS: Analysis revealed seven overarching themes: (i) views on what constituted medical error were well formed; (ii) to err is human; (iii) protocols exist to prevent error; (iv) trust in one's surgeon is important; (v) patients' belief that they can influence the likelihood of error was variable; (vi) concern with treating the disease trumps worry over possible errors; and (vii) the usefulness of discussing potential error was variable. CONCLUSIONS:Patients had a good understanding of medical error and it's potential causes. The usefulness of pre-operative, pre-consent discussion of error was varied. It may empower clinicians and patients to talk about such issues, though this should avoid exacerbating a patient's anxiety.