Abstract
Background Adverse events and medical errors are challenging aspects of clinical care delivery, and also present challenges as topics for research. Nonetheless, understanding how and why such errors occur is critical to rendering improvements. Using examples from a multi-site study of problems in cancer care, we identify potential pitfalls and strategies to consider when researching sensitive or thorny topics in our delivery systems.
Methods In the context of the CRN Cancer Communication Research Center our team is studying adverse events and medical errors in cancer care (both in primary and specialty care settings), and how communication could be use to prevent problems and/or respond to patients when something goes wrong in their care. Throughout the course of developing the study, the three sites encountered challenging dilemmas pertaining to risk management, quality improvement, stakeholder “buy-in” to the study idea, and IRB review.
Results Case studies within the larger context of a study on communication in cancer care will be presented to illustrate our approaches to addressing the challenges in each area. We will review how, in some instances, the anticipated challenges did not manifest themselves, and what has been required on the part of the study team to ensure ongoing buy-in, even as findings from the actual research study illuminate deficits in care.
Conclusions Sensitive research topics, especially those which may reveal opportunities for improving medical care, or confronting a persistent problem in quality of care, require particular attention to partnerships with key leaders, frequent communication, and an openness to modifying the research to meet the needs of both the study team and the clinical setting.
