IDEA FROM ROAD: Remember Family Perspective with Disclosure
I was recently speaking with a risk manager who is launching a disclosure program, and part of her implementation process is getting folks in the organization to remember the family perspective on disclosure. She is really stressing this point. Remembering that how the famly feels about the conversations and actions post-event is absolutely critical.
This is an interesting point to put on your disclosure checklist, because we've heard plenty of stories where the clinician, risk manager, or insurer initially feels great about the disclosure process, but then is left scratching their heads when the family still files a lawsuit. Obviously the patient/family didn’t share the great feelings! It's tough because disclosure usually involves difficult conversations, so people are nervous, they become motor mouths, they race to explain the chart and their decision making process, etc.
We need to remember to S...L...O...W....D...O...W...N, catch our breath, and ask some simple questions of the patient/family: "How are you doing? Is this making sense? Can you repeat back to me everything we’ve discussed over the last 10 minutes so I know you are understand the materials we've covered? How does this feel to you? What are you thinking?"
This is also why earlier this year we recommended interviewing the patient/family post-event, and making this interview part of your formal review process. Disclosure is not a one-way street! We need to share information with the patient/family, but we also need to make sure they can share information with us -- including problems or concerns.