Unanticipated outcome’ can include good news
What is an "unanticipated outcome?" This is an excerpt from "Perspective on Disclosure of Unanticipated Outcome Information," a resource document available from the American Society of Healthcare Risk Management:
"The Joint Commission [Joint Commission of Health Care Accreditation, JCAHO] intent provision provides some insight into what constitutes an unanticipated outcome. It is a result that differs significantly’ from what was anticipated to be the result of a treatment or procedure. In theory, the JCAHO statement does not restrict the discussion to negative or bad outcomes. However, the placement of this patient safety standard and intent in the context of the patient safety provisions has left many with the belief that only negative’ unanticipated outcomes merit disclosure. Additionally, it appears that the intent is to link the requirement for disclosure of unanticipated outcomes to those results that constitute a renewal sentinel event.
"Some health care organizations may set their policy on the topic to match that of the JCAHO. Others may take a more expansive view. Thus it is quite possible that positive’ unanticipated outcomes might occur as a result of tests or treatment. For example, a pregnant woman who underwent ultrasound was told she was carrying twins. During delivery, it is learned that she was carrying triplets. All three are delivered quite healthy. This unanticipated’ outcome is positive, not negative. Another illustration involves surgery. A patient is informed that surgery will necessitate an extensive resection of his bowel and will definitely involve a temporary colostomy.
"Upon examination of the affected area, the surgeon determines that the patient’s condition is not as bad as thought preoperatively. Although a resection is done for the patient, it is far less extensive and no colostomy is performed. The outcome is unanticipated, but positive in terms of the impact on the patient’s body, lifestyle, recuperation, and long-term prognosis."
The statement goes on to say that "ASHRM believes that patients are entitled to information on both types of outcomes and that the disclosure of this information is part of the communication process that forms the context for the caregiver-patient relationship."
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