Lead clinicians should know AHLA disclosure guidelines
Lead clinicians should know AHLA disclosure guidelines
The American Health Lawyers Association (AHLA) guidelines on disclosure of serious adverse clinical events (SACEs) are an excellent compendium of all the issues that should be raised, says Ellen L. Janos, JD, an attorney with the law firm of Mintz Levin in Boston who often has helped hospitals make decisions regarding disclosure of adverse events.
“It’s a set of considerations, not requirements, and that’s what makes it so useful,” Janos says. “This is a resource you can pull out and go through it step by step to make sure you haven’t overlooked anything, that you’re covering all the right issues and decide whether to disclose and then how to go about it.”
Janos points out that not all of the issues raised in the guidelines should prompt an affirmative action. For example, the AHLA guidance suggests considering what records to turn over to the patient or family. Janos says the answer usually should be “none.” Handing over source documents could impede a free and frank discussion by clinicians, she says.
“I also think these guidelines should be required reading by certain clinical staff in hospitals, such as the vice president for medical affairs and president of the medical staff,” she says. “I don’t think they have a full appreciation for the full range of considerations that come into play with a disclosure like this.”
As useful as they are, one expert in disclosure reminds risk managers that the guidelines only come into play once you know about a SCAE. Don’t let adherence to the guidelines make you overly confident that you have adequately addressed the issue of adverse events and disclosure, cautions Dean Sittig, PhD, faculty member at the University of Texas Health Science Center at Houston, who specializes in clinical information systems and clinical decision support.
“The thing that worries me the most is that there is another kind of error where no one even knows it was made. I’m a big fan of disclosing, but there is still a huge number of errors that are unknown,” Sittig says. “These guidelines are useful when we know what happened, but we have to keep looking for the ones we don’t know about.”
Sources
• Ellen L. Janos, JD, Attorney, Mintz Levin, Boston. Telephone: (617) 348-1662. Email: [email protected].
• Dean Sittig, PhD, School of Biomedical Informatics, The University of Texas Health Science Center at Houston. Telephone: (715) 500-7977. Email: [email protected].
The American Health Lawyers Association (AHLA) guidelines on disclosure of serious adverse clinical events (SACEs) are an excellent compendium of all the issues that should be raised, says Ellen L. Janos, JD, an attorney with the law firm of Mintz Levin in Boston who often has helped hospitals make decisions regarding disclosure of adverse events.Subscribe Now for Access
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