Medical errors, disclosure, and the role of apology: a tool for ... - TMLT

More documents

Recommendations

Info

4. Pay attention and keep appropriate eye contact without staring. 5. Interact with your patient in a manner consistent with your prior relationship. Depending on the situation, some physicians may be comfortable placing a hand on the patient’s arm as a gesture of caring or reassurance. Other patients may prefer to have their personal space respected. 6. Never yawn. 7. Never look at your watch or room clock. 8. Make sure your phone calls are held. If possible, cell phones and pagers should be turned off. Consider leaving your pager or cell phone with your nurse, instructing her to take messages and to interrupt only if the call is urgent. It is preferable that you are not on-call. However, if that is not possible, explain the situation to the patient. Most patients will understand that you have a patient with an urgent need. Emotion: Heartfelt sincerity is extremely important in communicating with 7 patients in these situations. The tone of your voice, your word choice and good eye contact will help convey your sincere feelings and emotions. Make sure that you really mean what you say, or you may appear nervous, uncomfortable, or dishonest. Showing your human side can help strengthen the bond between you and the patient. Compensation: If the patient has truly incurred a demonstrable loss or 8 injury due to wrongdoing, he may expect compensation. When some degree of significant harm or loss has occurred for which compensation is appropriate, contact your insurer. However, it should not delay your meeting with the patient. Obviously, taking care of the patient’s immediate health needs is essential. Closing: It may be difficult to determine an appropriate length of time for 9 the meeting. It shouldn’t drag on forever and you don’t want to leave the impression that you are in a hurry. Don’t rush things but don’t prolong the meeting by making unnecessarily lengthy or repetitive statements. Don’t feel compelled to fill an uncomfortable silence. The patient needs closure, so let the patient talk. When you sense the discussion is coming to a close, ask the patient if he has anything further he would like to discuss. Advise him that further discussions will occur as other information develops or as he has questions. You can conclude the meeting by thanking the patient for meeting with you and encouraging ongoing communication. Assure the patient that you are always available.
Timing of True Apologies and other Communications Following Adverse Outcomes There may be situations when the family’s needs are urgent (i.e. patient death). As common sense suggests, apologies made tardily may not be well accepted. However, a precipitous apology before all the facts are known may be premature and based on erroneous assumptions. Additionally, some patients may require more time before they are emotionally ready to engage in these discussions. Because each situation is different, there is no perfect answer regarding when these conversations should occur. The following are some guidelines to help you decide. • Sooner is usually better. Don’t delay without a good reason. Don’t search for reasons to avoid a potentially uncomfortable situation. • True apologies should not be given if any significant uncertainty remains regarding your culpability or role in the situation. You don’t want to accept blame for something you may not have actually done or caused. If you apologize, even though you were not negligent, the patient may assume you are guilty. • The discussion should be deferred if the patient is emotionally labile and obviously not ready to listen. Profound grief, confusion, anger and other emotions can render the discussion meaningless. • If an attorney has been consulted to assist you in the matter, follow his advice. Should you contact your insurer first Again, there is no perfect answer to what obviously is an important question. Perhaps the best answer is that the more serious the potential harm, the greater the need to first visit with your insurer. Simple mistakes that cause inconvenience, minor discomfort or embarrassment to the patient can easily be handled on your own. Events that produced more significant injuries or economic loss to a patient clearly warrant a call to your insurer.
Page 1 and 2: Medical Errors, Disclosure and the
Page 3 and 4: Preface In recent years, health car
Page 5 and 6: Juries have forgiven physicians whe
Page 7: Recordings: You should not record y
Page 11 and 12: Resources Healthgrades. Healthgrade

Medical errors, disclosure, and the role of apology: a tool for ... - TMLT

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?