Perception of Practicing Physicians on Medical Errors Disclosure in Government Secondary and Tertiary Health Facilities in Abuja Nigeria

Abstract

Introduction: Prevention of medical error is important in ensuring the quality of patient care. The objective of this study is to compare the perceptions of physicians on the occurrence of medical errors and disclosure practices and to identify factors associated with the occurrence of errors and the barriers and motivations to disclosures. Materials and Methods: Eight focus group discussions (FGD) were conducted in six secondary and two tertiary health facilities. The facilities and participants were selected using cluster sampling and snowball techniques respectively. Qualitative data management was carried out using verbatim transcripts, followed by an interpretative account and finally summarization of coded themes. An observational checklist was used to identify drug prescription writing errors from 420 prescriptions, selected using a simple random sampling method. Quantitative data was analyzed using SPSS software. Chi-square test was used to assess associations between variables at a significance level of 5%. Results: Physicians’ perceptions based on the FGDs suggests very frequent occurrences of medical errors and the main factor associated with occurrences was lack of hospital equipment. The secondary health facilities were more likely to disclose medical errors. Lack of disclosure policy and malpractice insurance was a major barrier to disclosure. The secondary health facilities had more frequent prescription writing errors than the tertiary facilities: omission of patients’ age (75.2% > 33.3%; p=0.001); address (88.1% > 3.3 %; p=0.001). Conclusion: The physicians’ perception was that of a heavy burden of medical error occurrences and poor disclosure practices. The development of institutional policies on disclosure including malpractice insurance should be encouraged.