1) Disclosure is good for doctors as well as nurses, hospitals, and insurers. An enormous & growing body of data is showing that disclosure coupled with apology (when appropriate) actually reduces lawsuits, litigation expenses, and settlements/judgments. The key is anger....disclosure and apology keep a lid on anger, whereas traditional deny and defend risk management strategies increase anger felt by patients & families, and increase the likelihood of costly litigation.
2) Five-Star Customer Service, Informed Consent, & Good Communication Lay the Ground Work for Successful Disclosure. For disclosure to work, you have to be credible. You also have to begin building positive evidence early in the process. Patients and families want to be treated with respect at all times, and they also want to see doctors and nurses treating each other with respect. Absent these feelings, disclosure after an adverse event might appear to a patient/family as a form of manipulation. "Why is Dr. McGod being nice to me now?" will be the skeptical question rolling around the heads of your patients/families. Also, procedure specific informed consent will aid in credible disclosure discussions, especially where there was no error. Sorry....sending your nurse in five minutes before the procedure with a bunch of forms to sign doesn't count! You have to invest the time and energy upfront.
3) Empathetic "I'm Sorry" Immediately After The Adverse Event. Doctors should provide an empathetic I'm sorry immediately after an adverse event coupled with a promise of an investigation and customer service assistance such as food, lodging, phone calls, transportation, etc. "I'm so sorry this happened Mrs. Jones...I feel bad for you and your family." Notice: Doctors should NOT prematurely admit fault or assign blame. Also, do NOT get defensive. Simply say you are sorry the event happened (as you should be!) and you feel bad for the patient/family, acknowledge their feelings, promise an investigation, and take care or assist with any immediate needs of the patient/family.Show you care! And document the chart accordingly without emotion or speculation. Write down what you said, what you promised, and any questions or comments by the patient/family.
4) Call Somebody! Call your risk manager, insurance company, defense counsel, etc, immediately after the empathetic I'm sorry with the patient/family. Inform them of the situation and tell them you need assistance with an investigation that will lead to a resolution of the situation - which may include a real apology (I'm sorry I made a mistake) coupled with fair, upfront compensation (paid for by your insurer) or more empathy if no error occurred.
These are the four most basic Sorry Works! facts for doctors. Best part is doctors can do these four things now.... immediately....today!
To learn more about Sorry Works! - including how to develop a successful disclosure & apology program - we recommend the Sorry Works! Book. The book retails for just $24.99 per copy and is the complete "how to" manual on Sorry Works! Furthermore, at 103 pages, the book is a quick read, even for the busiest doctor.
Bulk order prices are available by contacting Doug Wojcieszak at 618-559-8168 or e-mailing doug@sorryworksk.net.
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