Written by Kimiko Dunbar
Spoon Feed
The AAP’s updated policy statement on the disclosure of adverse events supports early disclosure, a culture of safety, and mental health care for providers involved in adverse events.
What to do when something goes wrong
Research on pediatric adverse events is lacking; however, it’s estimated that 6% of patients have experienced preventable harm. Historically, clinicians were advised not to disclose medical errors to patients and families, but disclosure is now routinely encouraged. This is a policy statement from the AAP that examines the ethical, legal, and practical aspects of communicating medical errors to pediatric patients and their families. Here are some highlights:
- Emergency care settings have a high risk for medical error given the fast-paced environment, frequent interruptions, and care of complex patients that are less well known to staff. Errors in the ambulatory setting are related to meds, vaccines, diagnosis and transitions of care.
- Children with special healthcare needs or medical complexity, and those historically marginalized, have higher rates of error.
- Safety culture (i.e. an environment that fosters open and honest communication to minimize harm) is associated with safer care.
- Medical errors that occur in the confidential treatment of an adolescent can be disclosed to the adolescent alone; however, subsequent care for management of the adverse event may fall outside of confidentiality protections.
- Many, but not all, states have “apology laws” that protect statements of apology from being used against clinicians, but most laws only protect statements of sympathy such as, “I’m sorry for your suffering,” rather than statements of fault.
- Clinicians often experience significant turmoil in the event of a medical error; support systems should be implemented.
How does this change my practice?
While most adverse events are rooted in system rather than human errors, I’ll be especially careful in the care of patients at high-risk adverse events, especially when completing medication reconciliation or transitions of care. Will I say I’m sorry? I can imagine these words may slip out regardless, but it seems this is still an unnecessarily loaded statement that should be used with caution.
Source
Disclosure of Adverse Events in Pediatrics: Policy Statement. Pediatrics. 2025 Apr 1;155(4):e2025070880. doi: 10.1542/peds.2025-070880. PMID: 40090360
