"Everybody Makes Mistakes": Children's Views on Medical Errors and Disclosure.

PURPOSE: The aim of this study was to explore the views of chronically-ill pediatric patients on medical errors and disclosure processes. DESIGN AND METHODS: Semi-structured, qualitative interviews were conducted with twenty pediatric patients. Participants comprised ten children (8-12 years) and ten adolescents (13-18 years). Multiple methods using qualitative approaches were applied to explore and elicit views on medical errors, disclosure and recommendations for patient safety. For the children, art and play-based methods along with visual aids and vignettes were used to facilitate discussion. Older participants predominantly engaged in discussing the issue of medical errors through an examination of vignettes representing levels of harm. RESULTS: Participants revealed a range of perspectives including a strong desire to be told of errors. While they wanted those responsible for the error to be held accountable, they acknowledged that everyone makes mistakes. Children's rights and participation in patient safety as well as the existence of secret errors emerged spontaneously through the data analysis. CONCLUSIONS: Chronically-ill children want to know about errors, from the person responsible for the error, and consider apologies and genuine remorse to be critical for coping. Children acknowledge that disclosure requires a case-by-case analysis. PRACTICE IMPLICATIONS: The results have implications for how we view disclosure processes with children and how to engage them in patient safety.

Parental experiences of a developmentally focused care program for infants and children during prolonged hospitalization.

This study investigates parental experiences and perceptions of the care received during their child's prolonged hospitalization. It relates this care to the Beanstalk Program (BP), a develop-mentally focused care program provided to these families within an acute care hospital setting. A total of 20 parents (of children hospitalized between 1-15 months) completed the Measures of Processes of Care (MPOC-20) with additional questions regarding the BP. Scores rate the extent of the health-care provider's behaviour as perceived by the family, ranging from 'to a great extent' (7) to 'never' (1). Parents rated Respectful and Supportive Care (6.33) as highest, while Providing General Information (5.65) was rated lowest. Eleven parents participated in a follow-up, qualitative, semi-structured interview. Interview data generated key themes: (a) parents strive for positive and normal experiences for their child within the hospital environment; (b) parents value the focus on child development in the midst of their child's complex medical care; and (c) appropriate developmentally focused education helps parents shift from feeling overwhelmed with a medically ill child to instilling feelings of confidence and empowerment to care for their child and transition home. These results emphasize the importance of enhancing child development for hospitalized infants and young children through programs such as the BP.

Perceptions of online support for hospitalized children and adolescents.

This study identifies perceived outcomes following hospitalized children's participation in a pediatric online support network. Nineteen participants were interviewed, including child and adolescent patients who had used the network while in hospital, their parent/family caregiver, and a familiar health care provider. This triadic sampling approach provided a range of stakeholder perceptions. Results convey a wide spectrum of benefits and challenges in accessing and utilizing an online support network for hospitalized children. Participation in the network was identified as a means of fostering pediatric patient enjoyment, education, connection with peers, and coping. Information, social connection and distraction served as catalysts fostering positive outcomes for children. Identified barriers to network participation included inaccessibility and limited availability of computers, issues with technology, and discomfort with online interaction. Findings advance understanding of online networks as supportive resources for seriously ill children and their families.