A “disclosure performance gap” also is increasingly evident, and harmful errors often are not disclosed. “When disclosure does take place, it often falls short of meeting patient expectations for what these conversations should be about,” he said.
In addition, little prospective evidence exists regarding what types of disclosure strategies are effective, Dr. Gallagher said. “That makes it difficult to know not [only] whether to disclose or not, but [also] what to say to the patient. Effective disclosure ought to have a positive effect on quality.”
There are multiple rationales for disclosing errors to patients, Dr. Gallagher said. Error disclosure can be considered a part of informed consent, he added, saying, however, “This is an area where doctors and patients appear to be on somewhat different pages. Physicians focus on informed consent, while patients see it as truth-telling.”