The beginning of a new year is a time filled with anticipation, especially when you are starting out as an intern or moving to a new hospital. For a junior doctor it can be somewhat daunting; everyone has heard the stories of the challenges it brings to both your personal and professional lives.

Junior doctors are more vulnerable to some of the issues that come with practising medicine in a busy hospital; lack of experience, intense work schedules and frequent rotations and often a lack of support means that the risk of errors occurring is high.

The key to managing this is understanding why medical errors occur, how they can be prevented and what to do when something goes awry.

Medical error

Patient safety is dependent on the skills, attitudes and actions of healthcare professionals, and also the systems and processes in place to support their work. Medical error is rarely caused by bad individuals. Often it is the end result of bad systems.1

It is recommended that you familiarise yourself, as quickly as possible, with the systems, protocols and procedures that are in place for your new workplace. Ask questions and don’t be afraid to ask for help from your Consultant, Registrar and nursing staff.

After an error occurs

Tell your consultant and/or supervisor straight away. Your initial reaction may be to manage it yourself and say nothing but ultimately this doesn’t help anyone. You may feel fearful of how the error will impact on your career and your relationships with your seniors and peers. Stepping up, being honest and taking responsibility are qualities that will be respected by those around you.

When a medical error happens, it is a very stressful time but the priority must be in ensuring that the patient is looked after and protected from further injury or harm. Your Registrar or Consultant will support and guide you through the management of the patient and treatment required following the error.

Documentation and reporting

Once the patient is safe from any further harm or ill effects of the error, it is essential that you spend some time writing a clear, accurate and contemporaneous record of what happened. These notes will be your greatest ally should a claim or complaint be made in the future.

Understand the reporting requirement for the health care setting you are working in. Incident reporting creates an opportunity to understand why the error occurred and how it can be prevented in the future. This is usually managed by the Clinical Governance Team or a Patient Safety Manager.

Discussing the event with the patient, providing a clear explanation and apology for what has happened and any long and short-term effects, is an important part of error management. As a junior doctor you will not be responsible for the open disclosure discussion with the patient and/or family. However, it is important that you participate and contribute for both personal and professional learnings.

Familiarise yourself with your hospital’s complaints procedure and follow this if you receive a formal complaint. The hospital complaints department and your consultant will be able to guide you if this happens. We also recommend that you contact us for advice and support. If it’s urgent we are here to help you 24/7.

It is important to become part of the Patient Safety culture in your organisation. As the front line contact for patients and family you are likely to see and experience situations where errors can happen. Take responsibility for communicating the potential risks and implementing solutions – you will not only be protecting your patients but yourself and colleagues.

1 Medical error. What to do if things go wrong: a guide for junior doctors. (National Patient Safety Agency (UK), June 2010)

Other resources

  1. Medical error

    What to do if things go wrong: a guide for junior doctors

  2. MIGA Workshop “Errors in health – exploring the human factors”

    Log in to the Client Area to book online

  3. MIGA Incident Notification Guide

  4. MIGA Incident Notification Form

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