It’s not what you say, it’s how you say it
It’s not what you say, it’s how you say it
Here are some tips for how to disclose unanticipated outcomes, such as injuries that occur during surgery:
• Be careful about who actually delivers the news.
People’s personalities come into play when it’s time to have a delicate conversation. Geri Amori, PhD, ARM, FASHRM, president of Communicating HealthCare, a risk management consulting firm in Shelby, VT, and president of the American Society for Healthcare Risk Management, says she once had two doctors consult her about how to deliver the bad news of a surgical injury. "I talked to one first and then I talked to the other one about what happened," she says. "Then I said to the first one, Let her do the talking.’ How you say it has an impact on how it’s heard and the first guy just didn’t come across very well."
Grena Porto, RN, ARM, DFASHRM, director of clinical risk management and loss prevention services at VHA Inc. in Berwyn, PA, and past president of ASHRM, agrees, adding that "there are some doctors you don’t want to talk to a patient about an error even if they did it because they’re just not good with people." In those cases, she suggests choosing from a number of other people, such as the patient representative, a supervising physician, the risk manager, or even the hospital CEO.
• Be prepared for any reaction.
Things can get dicey if the health care provider thinks he or she is delivering news of an unanticipated but insignificant outcome and the patient reacts with anger. If the provider is not ready for that, he or she may react by dismissing the patient’s concerns, which would only escalate the tension. Remind doctors and staff to look at the issue from the patient’s perspective. What seems minor to the clinician may not seem minor at all to the patient.
• The risk manager should not hover too much.
It may not be a good idea for the risk manager to always be present when unanticipated outcomes are disclosed. If the matter is not serious, the presence of the risk manager can lead the patient to fear that something is being held back or encourage the patient to think of legal remedies. In other words, Porto says, the presence of the risk manager can look defensive and cause the patient to wonder what the hospital is scared of. A better solution might be to have the risk manager informed of when and where disclosures are made, and then be available for immediate consult or to join in the meeting if necessary.
• Have an authority figure disclose significant unanticipated outcomes.
When you must tell the patient of a serious development, such as an accidental injury by a doctor or staff member, it might be best to have that news delivered by someone in authority instead of the person who actually made the mistake. This applies even to doctors, Porto says. "If the mistake is severe enough, they may want to hear it from someone very high up. They need that sometimes," she says. "That conveys that the organization is taking this matter seriously and has sent someone who is authorized to do something about it."
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.