Consumer Research on Messages to Prevent Medical Errors

Health Care Financing Review, Summer 2001 | Go to article overview

Consumer Research on Messages to Prevent Medical Errors


INTRODUCTION

Are Medicare beneficiaries able to play an active role in preventing medical errors? In response to the Institute of Medicine's report documenting the prevalence of medical errors, the Federal Government has begun to develop messages to encourage patients to take an active role in reducing medical errors. Much of this work has been spearheaded by the Agency for Healthcare Research and Quality (AHRQ), which has developed 20 Tips to Prevent Medical Errors. The Centers for Medicare & Medicaid Services (CMS) is also interested in promoting behaviors to prevent medical errors among its 40 million beneficiaries. As such, CMS conducted research to assess older adults' thoughts about preventing medical errors and to test their responses to existing messages.

STUDY OBJECTIVES

The objectives of the research were twofold, to identify the:

* Individual messages on error prevention that resonated most with beneficiaries.

* Types of patient-provider relationships that beneficiaries prefer.

PARTICIPANTS

Findings were based on the results from eight 2-hour focus groups, which took place in May 2000 in Baltimore, Maryland and Richmond, Virginia. Each focus group contained nine Medicare beneficiaries. Participants were evenly divided between males and females; 38 percent were black while 62 percent were white; ages ranged from 65 to 80. In both locations, two of the groups were composed of participants with lower education (high school or less) and two with higher education (some college courses or more).

PROCEDURES

In all eight groups, moderators probed what the term "medical errors" meant to participants; their receptiveness to the concept of interacting with health providers assertively and in self-protection; and the kinds of relationships they valued with health providers. Additionally, in six of the groups, participants were asked to rank 28 messages, packaged as "tips," about what patients can do to reduce medical errors. Most of the messages were drawn from AHRQ's 20 Tips brochure; the additional eight messages were developed by CMS staff or came from other organizations interested in reducing medical errors. Each of the 28 messages were placed in one of the following subject categories: hospital/surgery issues; prescriptions; and general thematic issues. Participants were asked to rank the tips in terms of how likely they were to act on them. After each category was ranked, the tips ranked the highest and lowest were discussed by the group as a whole. During these discussions, moderators asked the participants why they ranked certain tips high or low, what the tips meant to the participants, and how the participants would implement the action recommended by the tips.

FOCUS GROUP FINDINGS

Medical Errors and Their Contexts

Focus group participants were asked: "What comes to mind when you hear the term `medical errors'?" Immediately, participants discussed surgical errors that they had heard about in the media (e.g., people having the wrong leg amputated). Discussions also included pharmaceutical and diagnostic errors. Respondents were clearly aware that medical errors could occur around medicines. Usually, the pharmaceutical and diagnostic error discussions lasted longer because many participants recalled personal stories.

HIGH AND LOW SCORING TIPS

Messages that received the highest rankings tended to be those that indicated specific ways for patients to inform their health professionals, and to inform themselves about what their health professionals were doing. In the general thematic category, more specific tips (e.g., "Speak up if you have questions or concerns.") resonated with participants more than general prescription tips (e.g., "Be an active member of your health care team.").

Highest ranked messages stressed a keeping your doctor informed theme. Participants also preferred messages advocating actions they could accomplish. …

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