Medical errors happen. Period. End of story. How you disclose medical errors however is critical to your organization's reputation and could even save it from costly malpractice suits. In fact how the news is delivered may be more important than what is actually said.
Yet many organizations have not been able to bring themselves to the point of disclosure. Many reasons are given. They're embarrassed; afraid their reputation will suffer, and often believe that disclosure will do more harm then good. And of course the fear of being sued is a motivator to keep quiet.
Yet one could argue that disclosing errors is morally and ethically correct. And it can improve patient and resident safety. After all if no one owns up to an error, in many cases, it may not be discovered.
The movement toward patient / resident safety really snowballed after the report To Err is Human was published in 1999. It was reported that nearly 100,000 people die in any given year from medical errors, many preventable.
The Joint Commission has accreditation standards in place that require health care providers to inform patients about "unanticipated outcomes." In 2006, the National Quality Forum (NQF) added disclosure of adverse events to its manual on safe practices. Recognition by these organizations underscores the importance of disclosure."Deny and defend" has historically been the defense mechanism utilized by providers who have caused unintended medical harm. Studies have shown that this response does not meet the emotional needs of the patient or clinician.
- Don't beat yourself up. Mistakes happen.
- Follow protocols set to notify the appropriate authorities within and outside the organization.
- At all times, preserve the confidentiality of the patient.
- Investigate. Document.
- Determine who should talk to the patient/resident and family.
- Anticipate questions and have your answers ready but not down pat. Remember this is about having a conversation.
- Find a quiet and private place to have a conversation.
- Find out what the resident/patient and family understand already.
- Then further explain the nature and cause of the error. Go slow. Speak in simple terms. Give them time to absorb it all.
- Be empathetic and compassionate.
- See input from the resident and family.
- Explain the known consequences and the actions that need to be taken to treat the error.
- Discuss the investigation with the patient/resident and family. Make clear what will happen with the results of that investigation.
- Appoint a liaison who will work with the resident/patient to address further concerns and questions. Schedule follow up meetings if warranted.
- Point family to outside support and counseling that is available.
Take a breath. Remember to take care of the party responsible for the mistake. Take care as in display the same compassion and empathy as with those harmed. Most cases are not intentional or egregious. So the person(s) who made the mistake are suffering too.
A December 2010 study revealed that when healthcare providers tell patients about medical errors that happened under their care, the patient is twice as likely to recommend that provider to someone else than if they had not been told about the mistake. So as they say every cloud has a silver lining.