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5 Steps for Talking to Patients After an Adverse Outcome

Having proper training in how to speak to a patient and family after an adverse outcome is important to supporting the patient, reestablishing trust, and limiting malpractice liability.

Follow these five steps when speaking to a patient:

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  1. Acknowledge the Impact of the Event from the Patient and Family’s Perspective.  Even though the outcome may be a common complication of a procedure or routine from a clinical perspective, for the patient and his or her family, the situation is significant and often traumatizing.
  2. Understand the Patient’s and Family’s Expectations and Align Them with Clinical Results. Expectation management is a key risk management strategy and also helps the patient and family form realistic expectations of clinical realities. Communicating the plan of care and prognosis in lay language is important to helping patients and their families cope and prepare for the future.
  3. Help Them Understand. In the aftermath of an unanticipated outcome, patients and families need to make sense of what happened. In general they want to know:  What happened? Why did it happen? And, in situations of preventable harm: What can be done to prevent it from happening again?  
  4. Coordinate Disclosure with the Team and the Patient. The wise physician calls a huddle with the health care team to coordinate disclosure and ensure that information provided is consistent among all providers – including nursing.  You may not have all the answers immediately following the event and speculation must be avoided.   Physicians can, however, reassure the patient that they will do their best to answer the patient’s questions once the facts are clearly understood.
  5. Offer Empathy and a Plan:  The initial conversation is the right time to share an empathetic response such as, “I’m sorry you are experiencing this complication. As we discussed before your procedure, we knew this was a risk.  Let’s talk about what we can do moving forward…”

 

Author Lee McMullin is a certified Professional in Healthcare Risk Management with more than 25 years of experience in claims and risk management.  He is part of the CAP Cares Team which supports the CAPAssurance program offering hospitals, large medical groups, and other health care facilities top-rated risk management services. He is also the President of the Southern California Association for Healthcare Risk Management (SCAHRM).

 

If you have questions about this article, please contact us. This information should not be considered legal advice applicable to a specific situation. Legal guidance for individual matters should be obtained from a retained attorney.