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Protocol for Informing Patients of Serious Events or Incidents

Below are some things to keep in mind when informing patients of serious events or incidents.

• The best person for informing the patient is the attending physician or the physician with overall responsibility for managing the patient's care.
• Using another individual (non-physician) may send the wrong signal to the patient.
• However, the physician should be sure to include patient support personnel (social work, clergy, etc.).
• Immediately discuss the issues with risk managers and colleagues to get their perceptions of what happened to assure accuracy.
• Prepare an explanation ahead of time and prepare yourself emotionally for the encounter.
• Discuss what you plan to say with anyone else participating in discussions with the patient as well as appropriate institutional officials.

When informing patients, physicians should keep the following in mind:

• Appear on time for any appointment with the patient or representatives.
• Acknowledge the event in writing. (Written portion now required by law).
• Be sure to apologize.
• Accept your own fallibility in an empathetic manner.
• Express your sympathy and regret over the incident.
• Empathize with your patient. Acknowledge and empathize with the feelings of frustration and suspicion.
• State all that you know at present, admit that you don't have all the answers and will provide additional information when it becomes known.
• Explain what action you are taking regarding the problem and describe what you are doing.
• Assure that a full investigation will take place.
• Provide a contact for the patient or representative and be sure to promptly answer all calls and inquiries.

Sources:

Brock D. Nelson, Children's Hospital and Clinic, Minneapolis, St. Paul. 2001, Creating A Culture for Patient Safety. Presentation to "Let's Talk: Communicating Risk and Safety in Health Care"

Daniel O'Connell, PhD, Bayer Institute. 2001, We Made a Mistake. Presentation to "Let's Talk: Communicating Risk and Safety in Health Care"

John R. Combes, MD, Hospital and Healthsystems Association of Pennsylvania. 2002 Presentation: Patient Safety Issues for Hospital Boards

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