Disclosure is a complex process, not simply an opportunity to sit at the patient’s bed side and say you’re sorry, says Julie Morath, RN, MS, chief operating officer and vice president of care delivery at Children’s Hospitals and Clinics of Minnesota in Minneapolis. Her hospital has developed an extensive protocol for how to disclose adverse events, which starts with an apology but moves on to providing all the information that the patient or family will want.
During initial and follow-up discussion, Morath says the following subjects may be discussed, although discussion of each subject on this list is not required, nor is discussion limited to these topics:
- that Children’s and its staff regret and apologize that an accident has occurred;
- the nature of the accident;
- the time, place, and circumstances of the accident;
- the proximal cause of the accident, if known;
- the known, definite consequences of the accident for the patient and potential or anticipated consequences;
- actions taken to treat or ameliorate the consequences of the accident;
- who will manage ongoing care of the patient;
- planned investigation or review of the accident;
- who else has been informed of the accident (in the hospital, review agencies, etc.);
- actions taken, if any, to identify system issues which may have contributed to the accident and to prevent the same or similar accidents from occurring;
- who will manage ongoing communication with the family;
- the names and phone numbers of individuals in the hospital to whom the parents may address complaints or concerns about the process around the accident;
- the names and phone numbers of agencies to whom the family could communicate about the accident;
- how to obtain support and counseling regarding the accident and its consequences both within Children’s and from outside of Children’s;
- that charges and expenses directly related to the accident will be removed from the patient’s account;
- that Children’s will assist the family in referral to resources to help them obtain compensation if actual damages warrant.
Disclosure is a complex process, not simply an opportunity to sit at the patients bed side and say youre sorry, says the chief operating officer and vice president of care delivery at Childrens Hospitals and Clinics of Minnesota in Minneapolis.
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