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THIS WEEK'S EDITION:
- Leapfrog Group calls on hospitals to apologize to injured patients after never events
- Insurer's interest in Sorry Works! continues to be high
- Healthcare professionals - give yourself a Christmas present today!
- Perfect stocking stuffer/CME & CEU credits
- Question & Answer
LEAPFROG GROUP CALLS ON HOSPITALS TO APOLOGIZE TO INJURED PATIENTS AFTER NEVER EVENTS
Approximately two weeks ago the Leapfrog Group issued a call to hospitals to commit to its Never Events policy which includes apologizing to injured patients. According to the Leapfrog Group, "Never events are rare medical errors such as surgery performed on the wrong body part, leaving a foreign object inside a patient after surgery, or an infant discharged to the wrong person. They are clearly identifiable, largely preventable, and serious in their consequences." For more information, visit www.leapfroggroup.org.
INSURER'S INTEREST IN SORRY WORKS! CONTINUES TO BE HIGH
Sorry Works! is a hot topic that is getting hotter each day in the insurance industry. Sorry Works! has been recently asked to submit one article to a major insurance publication, and we will be part of another article submitted to another major insurance publication. Stay tuned.
Also, Sorry Works! spokesperson Doug Wojcieszak was invited to speak to ProMutual Insurance in January and PLICO in March and September. Great developments.
Please help to keep the momentum going in the insurance industry by spreading the word with these newsletters and our website. Thanks!
HEALTHCARE PROFESSIONALS: GIVE YOURSELF AN EARLY CHRISTMAS PRESENT TODAY
Healthcare professionals can give themselves an early Christmas present by calling or jotting an e-mail to their insurance company to discuss Sorry Works. We're serious....call or write today and you may be thanking yourself for a long time to come. As written above, insurers are already interested in Sorry Works....but they need to hear from doctors, nurses, risk managers, and hospital administrators. They need to hear your interest and get you and your colleagues involved in the process of developing Sorry Works! disclosure programs. Adverse events don't have to mean that doctors and patients become enemies or that healthcare professionals have to spend sleepless nights worrying about lawsuits, depositions, and trials. Give yourself a present and take control of your liability exposure by encouraging your insurer to adopt Sorry Works! Call or e-mail today. Happy holidays!!
THE PERFECT STOCKING STUFFER/CME & CEU credits
Malls too crowded? The box of stale chocolates or cheap wine bought over the Internet won't make for a cool Yule? Don't despair...Santa is here with the Sorry Works! audio conference CD to spread holiday cheer. Get yours today by contacting our friendly elf Melanie Gober at mgober@rmpsi.com or call 517-886-8226.
Better yet, ol' St. Nick informs us that the Sorry Works! audio conference can count for CME and CEU credits for two (2) full- years after the conference date (November 14, 2006). So, gather the staff around, pour some egg nog, pass the Christmas cookies, and earn 1.5 AMA PRA Category I CreditsTM and/or 1.8 nursing contact hours by listening to the Sorry Works! CD.
Don't be a Scrooge - order your CD today and make all the folks on your list happy. Ho, ho, ho!
QUESTION & ANSWER
Welcome to this week's Q&A with Dr. Geri Amori, RM&PSI Senior Director (www.rmpsi.com) and experienced risk manager, educator, and counselor and Doug Wojcieszak, Founder and Spokesperson of The Sorry Works! Coalition (www.sorryworks.net). This week's question comes from the recently completed Sorry Works! audio conference. Over the next few weeks will be sharing some of the questions we received from the audio conference.
Question: "At what point do you initiate conversations regarding compensation? Do you come prepared to offer compensation at the time of full disclosure? If so, how do you evaluate for damages if you don't have information regarding wages, children, etc."
Doug: The very first disclosure meeting usually happens in the immediate after math of the event. Go to the family or patient, tell them something has happened, attend to their immediate needs, and let them know you will do a quick and thorough investigation and promise to get back to them at a certain date.
If the investigation shows there was an error, then you need to consider compensation. However, understand that there are four elements to effective apology and disclosure after a legitimate medical error: 1) "sorry" or apology; 2) admission of fault; 3) explanation of what happened and how steps will be taken to prevent it from happening again; and 4) offer of fair, upfront compensation.
These elements must generally be given in this order and may take several meetings to deliver effectively to the patient or family. The last element - compensation - may take the longest to deliver and resolve. However, if a patient or family has suffered serious financial harm due to error they and their attorney are going to need to hear pretty quickly in the process that you intend to offer fair, upfront compensation. Then, the actual amount to be paid will be determined over several meetings where you discuss and learn the actual amount of lost wages, children, and other economic factors.
Some medical providers are understandably slow in discussing compensation – some because they think it "cheapens" or degrades the disclosure event and others because they are still uncomfortable having to pay for errors. However, families and patients want to hear their economic problems are going to be addressed. If all patients and families hear at the beginning is "we're sorry and we’ll do better next time" they might start to think that they are being snowed over with a phony, meaningless apology. Think about this issue from the customer perspective: "Hey this apology is nice, but my husband can’t work for six to twelve months – who is going to pay the bills and put food on the table? I guess I am going to have sue these doctors!"
You have to pay for errors it's the ethical thing to do. However, you don't want to look live you are buying people off. That's completely understandable. However, when you do the first three steps sincerely (apologize, admit fault, explain) then you look also very sincere and real when say, "And we also intend to offer fair compensation for your injuries, and we will be discussing the amount of this compensation with you and your attorney."
After medical errors, patients and families are emotionally raw… their trust has been violated and they have many worries. Don't be so cautious and slow in the compensation part of disclosure that you give your customers - the patients and families - the wrong idea. Thanks for the question!
Geri: The question about when to begin discussions of compensation is a fair one. Doug is right, letting people know that you intend to treat them fairly is important from the beginning. However, the night that you have the event and I am just learning of it may not be the time to begin that discussion UNLESS it is clear that a medical error has created the outcome and all the players are on board. Generally, as soon as an event occurs, the first priority is to take care of the patient and the family. During that INITIAL disclosure, the focus should be on the immediate needs of both. This may involve some money (Does the family need somewhere to stay that night, food, or other support?). For the most part, however, the immediate needs are medical care for the patient and support for the family. If there is a clear link between the outcome and a known error, you may say "We need to address the immediate needs tonight. It is our intention to be honest and fair with you. We will work with you to figure out what that means." Once you make this promise, you have set yourself in a position for subsequent conversations. It is key, however, that once you make this promise, you are true to it.
Before you actually begin talking about compensation, you will want to have done your RCA to know that there is a direct relationship between the outcome and the care. You will also want to have spoken with your risk manager, your insurer, and perhaps your attorney to ensure that everyone is on the same page. Recently I heard about an unanticipated outcome in which the physician began immediately talking about compensation, only to learn that there was no error. The patient's result was because of a previously unknown physical anomaly. The insurer was upset, and the physician felt uncomfortable.
Bottom line: 1) Make assurances of your intentions to be truthful, just and fair from the beginning. 2) Do the RCA quickly and thoroughly. 3) Ensure that all the appropriate parties are engaged. 4) Keep the patient/family posted on the progress of your work. 5) Approach when you know if an error was the cause and share that result. If the patient/family is ready, you can begin discussions of compensation assuming the right parties are at the discussion. 6) Engage the patient/family in helping you determine the financial implications. 7) If not all costs are known at the time, promise, and keep the promise, to complete the process of compensation as soon as possible. 8) Continue to communicate until the process is resolved. You may have to make a couple of payments. Ensure that whatever process you enter with the patient/family is respectful and trustworthy.
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