Patients' and doctors’ views and experiences of the patient safety trajectory of breast cancer care

TL;DR

This study explores patients and doctors' views on patient safety and medical errors in breast cancer care in Ireland.

Contribution

It is the first study to assess patient and doctor perspectives on medical errors and patient safety in Irish breast cancer care.

Findings

Doctors were more negative about patient safety than patients and reported concerns about communication and staffing issues.

Medical errors caused long-term physical, emotional, and financial impacts on patients.

Doctors involved in negligence claims considered early retirement due to emotional distress.

Abstract

Successful breast cancer outcomes can be jeopardised by adverse events. Understanding and integrating patients' and doctors’ perspectives into care trajectories could improve patient safety. This study assessed their views on, and experiences of, medical error and patient safety.

A cross-sectional, quantitative 20–40 item questionnaire for patients attending Cork University Hospital Cancer Centre and breast cancer doctors in the Republic of Ireland was developed. Domains included demographics, medical error experience, patient safety opinions and concerns.

184 patients and 116 doctors completed the survey. Of the doctors, 41.4% felt patient safety had deteriorated over the previous five years and 54.3% felt patient safety measures were inadequate compared to 13.0% and 27.7% of patients respectively. Of the 30 patients who experienced medical errors/negligence claims, 18 reported permanent or long-term physical and emotional effects. Forty-two of 48 (87.5%) doctors who experienced medical errors/negligence claims reported emotional health impacts. Almost half of doctors involved in negligence claims considered early retirement. Forty-four patients and 154 doctors didn't experience errors but reported their patient safety concerns. Doctors were more concerned about communication and administrative errors, staffing and organisational factors compared to patients. Multiple barriers to error reporting were highlighted.

This is the first study to assess patients' and doctors’ patient safety views and medical error/negligence claims experiences in breast cancer care in Ireland. Experience of medical error/negligence claims had long-lasting implications for both groups. Doctors were concerned about a multitude of errors and causative factors. Failure to embed these findings is a missed opportunity to improve safety.

•Many doctors have negative patient safety views and are more negative than patients.•Medical errors have long-term physical, emotional and financial impacts on patients.•Experience of negligence claims impacts doctors' choices about early retirement.•Multiple barriers exist to reporting errors or concerns for patients and doctors.

Many doctors have negative patient safety views and are more negative than patients.

Medical errors have long-term physical, emotional and financial impacts on patients.

Experience of negligence claims impacts doctors' choices about early retirement.

Multiple barriers exist to reporting errors or concerns for patients and doctors.

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