Successful remediation of patient safety incidents: a tale of two medication errors.

摘要: BACKGROUND As patient safety acquires strategic importance for all stakeholders in the health care delivery chain, one promising mechanism centers on proactive disclosure of medical errors to patients. Yet, and apology alone will not be effective fully addressing patients' concerns after an adverse event unless they are paired with a remediation component. PURPOSE The purpose this study was identify key features successful efforts that accompany APPROACH We describe contrast two recent very similar cases preventable error involving inappropriate medication at large tertiary-care academic center Midwestern United States. FINDINGS Despite their similarity, led different outcomes trajectories injured Although causing no permanent harm mismanaged lasting dissatisfaction patient, other resulted death but remediated point allowing family come terms loss even restored modicum trust providers' sincerity. PRACTICE IMPLICATIONS To maximize opportunities remediation, as soon possible incident, providers should pledge patients relatives assist them recovery long necessary then follow through pledge. case studies show, it takes training vigilance ensure adherence these principles reach optimal outcome relatives.