Institutional self-protection motives are part of the system which affect diagnostic error

Hamm, Robert M. (HSC) Robert-Hamm at OUHSC.EDU
Mon Dec 1 17:06:44 UTC 2014

Specifically, after a mistake, the details could be 1) publicized so others could learn, or 2) hidden, so this institution won't get sued.

Here is the "Health Care Renewal" discussion of the hospital's behavior after the patient's Ebola diagnosis was delayed.

Public Relations and the Obfuscation of Management Errors - Texas Health Resources Dodges its Ebola Questions<>
Not long ago, Texas Health Presbyterian hospital and its parent system, Texas Health Resources (THR), were in the headlines after the first patient to be diagnosed with Ebola in the US was admitted to Presbyterian.  The hospital arguably flubbed the initial diagnosis of this patient.  He was later admitted, very sick, and then quickly died.  Two of the nurses caring for him in turn were infected with Ebola, but survived, mainly in the case of specialized infectious disease units in other hospitals.  Many questions remained about the events at Presbyterian, whose answers might inform management of future Ebola patients, or patients with other novel infections.  Yet instead of answering them, THR has apparently loosed its dogs of public relations to obfuscate the issues, apparently to make its management look less bad.  The generic managers of health care organizations use numerous tools, including well funded PR departments, to advance their interests.  In this case, the interests of generic management appear to conflict with those of public health.  Yet so far the generic managers seem to be winning.  True health care reform would enable leadership of health care organizations by people who actually understand the health care context, and would be accountable to put patients' and the public's health ahead of self-interest.

Robert M. Hamm
Clinical Decision Making Program
Department of Family and Preventive Medicine
University of Oklahoma Health Sciences Center

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