7 Signs Providers Are Opening Up About Bad Healthcare Outcomes

Cheryl Clark, for HealthLeaders Media , December 19, 2013

Rather, "these are the people who have had special training to help healthcare workers get ready for the disclosure conversation," a kind of "just-in-time" support mechanism, Gallagher says.

For example, "if we have a surgeon in the operating room who experiences a significant complication with a patient, we would expect that, before they go talk with the family in the waiting room, they'd spend 10 minutes with a disclosure coach to talk a bit about what happened, [and] plan for that conversation with the family," Gallagher says.

Who trains the disclosure coaches? Training programs, like the one at the University of Virginia School of Medicine are popping up.

2. Peer-Reviewed Research
We're starting to see more scholarly articles exploring the topic...

In the New England Journal of Medicine, Gallagher and colleagues broached the topic of what obligations a physician has to disclose an error made by another practitioner, even if it means alienating a friend or network colleague. The paper concluded that clinicians should make efforts to involve the provider who made the error, even if that provider works at another institution.

Another article by Gallagher and colleagues in Health Affairs last year explored whether clinicians should offer compensation to affected patients and families at the point of disclosing the error, and whether that would impact the likelihood the patient would pursue litigation.

3. Standards and Guidelines
National organizations are developing prescriptive advice about how to disclose errors.

For example, last month the Agency for Healthcare Research and Quality awarded the American Hospital Association a contract to develop a comprehensive patient safety and medical liability communication and resolution toolkit [PDF] to "test a variety of efforts to improve patient safety and reduce medical liability costs through improved risk monitoring and communication with patients."

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