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Disclosure of Unanticipated
Outcomes and Medical Errors
Recently, the
Joint Commission for Accreditation of Hospitals and Organizations
(JCAHO) implemented a new standard requiring discussion with patients or
their representatives whenever outcomes differ significantly from the
anticipated outcome. In addition to the JCAHO,
others have always encouraged forthrightness when there has been a
disappointing outcome of care, including when there has been a medical
or system error involved in the patient injury.
In addition to their sensitivity to the
patient and family’s experience of disappointment, clinicians and
healthcare organizations are deeply fearful of malpractice suits. They
lack confidence that they can have constructive disclosure
conversations. As a result, simply telling clinicians that they “ought”
to disclose an unanticipated outcome or error is ineffective.
In late 2003, MPSC members underwent a train the trainer program sponsored by the
Bayer Institute for Health Care Communication to teach a workshop titled
"Disclosing
Unanticipated Adverse Outcomes and Medical Errors" to healthcare workers
in the community.
The workshop addresses each aspect
of the analysis and communication process using lecture, video examples,
small group practice and discussion to identify and practice the most
effective ways of understanding and responding in these situations. At
the end of the workshop participants will:
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Understand and identify with the rationale for greater openness when
there has been disappointment with care and possibly injury associated
with medical or systems error
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Recognize and appreciate others’ perceptions of the situation (e.g.,
patients, family, colleagues, staff)
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Know
and be able to enact the steps to take before, during and after
disappointing outcome
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Acknowledge and respond constructively to the emotional and ethical
challenges in these situations
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Demonstrate the disclosure skills in a variety of clinical situations
The workshop
acknowledges that unanticipated adverse outcomes may occur with or
without their having been medical or systems errors (deviation from the
standard of care). Both require discussion with patients and families
whose perceptions and sensitivities must be understood and skillfully
addressed. When medical or systems errors have contributed to the injury
the clinicians and organization have additional responsibilities and the
requirement for coordination among a broader set of stakeholders poses
additional challenges.
CME credit is also
available through the Bayer Institute.
For
information on the next disclosure class please contact Kendra
Jacobsen at
kjacobsen@meriter.com or call (608) 417-5889.
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| Classes on
disclosure are offered on:
no upcoming class is scheduled at
this time
For registration and details please contact
Kendra Jacobsen at (608) 267-5889 |
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