Letter to the Editor
Learning from error in orthopaedic surgery and traumatology
Aprender del error en Cirugía Ortopédica y Traumatología
C. Martin-Fumadóa,b,c,
, J. de Casod,e, A. Carreras-Castañerf, J. Arimany-Mansoa,b,g
Corresponding author
a Área de Praxis, Servicio de Responsabilidad Profesional, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, España
b Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, España
c Facultad de Medicina, Universitat Internacional de Catalunya, Barcelona, España
d Sección Urgencias, Servicio de Cirugía Ortopédica y Traumatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
e Departamento de Cirugía, Universitat Autònoma de Barcelona, Barcelona, España
f Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, España
g Departamento de Salud Pública, Universidad de Barcelona, Barcelona, España
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"apellidos" => "Martin-Fumadó" "email" => array:1 [ 0 => "carles.martin@comb.cat" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "J." "apellidos" => "de Caso" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Carreras-Castañer" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Arimany-Manso" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] ] "afiliaciones" => array:7 [ 0 => array:3 [ "entidad" => "Área de Praxis, Servicio de Responsabilidad Profesional, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, España" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Facultad de Medicina, Universitat Internacional de Catalunya, Barcelona, España" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Sección Urgencias, Servicio de Cirugía Ortopédica y Traumatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Departamento de Cirugía, Universitat Autònoma de Barcelona, Barcelona, España" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, España" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Departamento de Salud Pública, Universidad de Barcelona, Barcelona, España" "etiqueta" => "g" "identificador" => "aff0035" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aprender del error en Cirugía Ortopédica y Traumatología" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read the interesting article published in <span class="elsevierStyleItalic">Revista Española de Cirugía Ortopédica y Traumatología</span> (RECOT) entitled “Influencia de las reclamaciones en la gestión asistencial de un servicio de cirugía ortopédica y traumatología” (Influence of complaints on care management in an orthopaedic surgery and traumatology department) by Combalia et al.,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> which reviews the complaints filed in an orthopaedic surgery and traumatology (OST) service with the aim of identifying opportunities for improvement secondary to the evaluation of these complaints.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We fully agree with the authors that, nowadays, following the acceptance of the inevitability of error in medical practice and, by extension, in healthcare activity, the only possible strategy, from all approaches, is to learn from these errors. This has been the case in the field of medical professional liability claims over the last decade as a result of a change in the management model, from a model based on the mere assurance of the activity to an analytical and research model focused on the proposal of clinical safety recommendations clínica<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a> which has proved to be very profitable. In the specific case of TOC, in our context, the potential benefit of such initiatives is maximised given that it is one of the most sought-after specialties.</p><p id="par0015" class="elsevierStylePara elsevierViewall">At the same time, in the strictly clinical setting, there is no doubt about the benefit of incorporating continuing medical education strategies such as formative feedback for healthcare professionals based on learning from errors, which is seen as a useful tool for improving clinical safety.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Furthermore, the study by de Combalia et al.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> rightly concludes that the implementation of stable information procedures to modulate patient expectations and more empathetic communication that facilitates a good patient-professional relationship are actions that reduce the presentation of complaints. Again, we fully agree with the authors. Lack of communication or poor communication damages the patient–physician relationship and can be a potential cause of complaint.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a> The same is true for the systematic communication of medical errors to patients in accordance with ethical, deontological and clinical safety principles. The current practice of medicine requires that practitioners and healthcare institutions approach aspects of communication and information provided to patients proactively, truthfully, transparently and in detail. In the communication of medical errors to patients, for example, such communication facilitates the creation of opportunities for patients and their families to become part of the solution, to truly learn from errors, and to improve trust in the doctor-patient relationship, again resulting in higher quality medical care.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Level of evidence</span><p id="par0025" class="elsevierStylePara elsevierViewall">Level of evidence V.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0030" class="elsevierStylePara elsevierViewall">There were no external sources of funding.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">There were no conflicts of interests.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Level of evidence" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Combalia A, Torà-Rocamora I, Diestre-Tomas A, Muñoz-Mahamud E, Grau-Cano J, Prat-Marín A. Influencia de las reclamaciones en la gestión asistencial de un servicio de cirugía ortopédica y traumatología. Rev Esp Cir Ortop Traumatol. 10.1016/j.recot.2022.01.004" ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Legal medicine contributions to patient safety. From ascertainment and evaluation to research in medical liability" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E.L. Gómez-Durán" 1 => "C. Martin-Fumadó" 2 => "J. Arimany-Manso" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00414-013-0885-9" "Revista" => array:6 [ "tituloSerie" => "Int J Legal Med" "fecha" => "2013" "volumen" => "127" "paginaInicial" => "1051" "paginaFinal" => "1053" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23828623" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La comunicación del error médico. Consecuencias éticas y médico-legales" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Martin-Fumadó" 1 => "M. Morlans" 2 => "F. Torralba" 3 => "J. Arimany-Manso" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medcli.2018.07.013" "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2019" "volumen" => "152" "paginaInicial" => "195" "paginaFinal" => "199" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30297254" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/18884415/0000006600000006/v3_202403210638/S1888441522002016/v3_202403210638/en/main.assets" "Apartado" => array:4 [ "identificador" => "94616" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Cartas al Director / Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/18884415/0000006600000006/v3_202403210638/S1888441522002016/v3_202403210638/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441522002016?idApp=UINPBA00004N" ]
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