School of Public Health and Community Medicine

How supporting patient and professional recovery after medical errors could improve the safety of healthcare

Reema HarrisonDr Reema Harrison’s research focuses on quality and safety in healthcare, especially the psychological impact of medical errors. Dr Harrison, who joined the SPHCM in 2016, is a senior lecturer and co-director of the Health Management program. For Reema, a key attraction of SPHCM is the opportunity to do policy-relevant research that will have an impact on health services.

What is the main focus of your research?

I’m studying the psychological aftermath of adverse safety events (an incident that results in harm to a patient) and medical errors for both health professionals and patients, and how we can promote learning and recovery.  A pivotal paper in the BMJ almost 20 years ago [www.bmj.com/content/320/7237/726] pointed out that while patients are the first victims of medical errors, healthcare professionals who are involved in such events often also experience significant distress that not only affects their wellbeing but may also compromise the safety of patient care.

Errors are inevitable, particularly in increasingly complex health systems, so we need to prepare health professionals to be able to recover from these events and support their patients through them. Related to this work is my research around information sharing between healthcare organisations and patients after a safety event, particularly the challenges of implementing open disclosure policies in the UK and Australia. We need evidence-based strategies that support staff and organisations to harness opportunities for health service improvement that are identified in the context of errors and adverse events so they become an impetus for change.

Have there been any surprising results?

We started looking primarily at negative experiences associated with being involved with a medical error, but we’ve learnt that some positive change can also occur from these challenging events. Through surveying more than 2500 health professionals in several countries about their experiences of adverse events and errors, it is clear there is a substantial group who show resilience when involved in a medical error. These health professionals are determined to learn from their mistakes, sometimes becoming more confident in their abilities, and ultimately improve care for patients. I’m now working to identify what makes that group thrive.

What has been the impact so far of your research?

The main impact has been raising awareness of the issue. I am part of an international consortium of researchers in this area who have written extensively about this issue and presented the data at a range of forums across the globe.  I have also written for clinician publications to bring the issue to the forefront. For example, I wrote a piece for Clinical Medicine, the journal of the Royal College of Physicians, reporting the experiences of the organisation's members. My work relating to open disclosure has had significant policy relevance, with reports for the UK National Health Service and the NSW Ministry of Health about information sharing and open disclosure after adverse events.

What attracted you to the UNSW School of Public Health and Community Medicine?

When I considered moving to SPHCM, I could see it had many conjoint and affiliate researchers and affiliate centres. They weren’t just listed on the website – there were genuine industry and health service links to research and teaching programs. I have always developed my research through engaging with policy makers and health service organisations, so I knew SPHCM was right for me. I also enjoy working with the unique student group in the Master of Health Management. Many are highly experienced health service managers in different countries and that keeps me engaged in the contemporary issues affecting a range of health systems.

What else would you like to accomplish?

I’ve been selected for the UNSW academic women in leadership program next year, so I’ve been thinking about my goals. I want to continue to do policy-relevant research and to integrate that research into our teaching. Ultimately, I am keen to grow our research program around quality and safety in healthcare in the School that feeds into our Heath Management teaching program.