Implementation of duty of candour within neurosurgery: a national survey and framework for improved application in clinical practice
| Autor: | Parag Sayal, Hani J. Marcus, Peter J. Hutchinson, Neil Kitchen, R Ley, S Basu, Lewis Thorne |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
media_common.quotation_subject Neurosurgery Neurosurgical Procedures State Medicine Nursing Statutory law Surveys and Questionnaires Medicine Humans Duty Societies Medical media_common Quality of Health Care Physician-Patient Relations Medical Errors business.industry Health Plan Implementation General Medicine Clinical Practice Cross-Sectional Studies Neurosurgeons England Surgery Patient Safety business |
| Zdroj: | Ann R Coll Surg Engl |
| Popis: | Introduction Statutory duty of candour was introduced in November 2014 for NHS bodies in England. Contained within the regulation were definitions regarding the threshold for what constitutes a notifiable patient safety incident. However, it can be difficult to determine when the process should be implemented. The aim of this survey was to evaluate the interpretation of these definitions by British neurosurgeons. Materials and methods All full (consultant) members of the Society of British Neurological Surgeons were electronically invited to participate in an online survey. Surgeons were presented with 15 cases and asked to decide in the case of each one whether they would trigger the process of duty of candour. Cases were stratified according to their likelihood and severity. Results In all, 106/357 (29.7%) members participated in the survey. Responses varied widely, with almost no members triggering the process of duty of candour in cases where adverse events were common (greater than 10% likelihood) and required only outpatient follow-up (7/106; 6.6%), and almost all members doing so in cases where adverse events were rare (less than 0.1% likelihood) and resulted in death (102/106; 96.2%). However, there was clear equipoise in triggering the process of duty of candour in cases where adverse events were uncommon (0.1–10% likelihood) and resulted in moderate harm (38/106; 35.8%), severe harm (57/106; 53.8%) or death (49/106; 46.2%). Conclusion There is considerable nationwide variation in the interpretation of definitions regarding the threshold for duty of candour. To this end, we propose a framework for the improved application of duty of candour in clinical practice. |
| Databáze: | OpenAIRE |
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