Medical error consciousness and perception among clinicians and surgeons. Results of a cross-sectional study in a Teaching Hospital in Rome

Introduction The study was aimed to explore the consciousness of medical error among health professionals stratified by clinicians and surgeons, within the Teaching Hospital Gemelli in Rome. Materials and Methods A questionnaire, consisting of two questions about most serious and frequent mistakes, was administered to participants of a course. Data were collected, stratified in macro-categories and analysed applying ²-test. Statistical significance was set at p≤0.05. Results A total number of 988 questionnaires was collected; 2340 errors referred as the most serious and 2111 as the most frequent were indicated. The errors considered as the most serious are represented by: exchanges (18.7%); therapy administration (16.5%); communication (11.3%). The errors considered as the most frequent are represented by: communication (15.2%); exchanges (14.2%); therapy administration (11.5%); prescription (10.9%). The analysis of error macro-categories showed significant differences between clinical and surgical departments for both the most serious (p=0.038) and the most frequent errors (p=0.004). In particular procedures/protocols mistakes represent the errors mostly perceived as frequent with the highest percentage (29%) among clinicians, but not among surgeons (23.4%). Discussion and conclusions Differences between clinicians and surgeons about procedures/protocols mistakes may be due to an higher standardization of surgical processes than clinical, which contributes to a reduction of the number of related errors and near misses. The weight of communication and information seems to be predominant versus other error classes. The engagement is to promote and encourage clinical risk management culture and to try Clinical Governance tools allowing to monitor, limit and prevent medical errors.