1. Rita Simmons
Sr. Director, Operations Risk Management

2. Managing Risk Through Effective Communication - Apology & Disclosure

3. Known Benefits of a Disclosure Program
Direct Benefits:
Improves employee and patient/resident satisfaction
Engages physician in disclosure process and fosters patient-centered approach to care
Healing on all sides after an error
The disclosure is not just about the patient its about the employee too
Promotes trust through transparency
Facilitates appropriate closure of issue
Improves safety
Improves care
Improves communication
The Case for Apology:
First and foremost, you apologize because it is the right thing to do
Mistakes happen, but it is how we respond to those mistakes that will help
define the outcome

4. What Patients Consider Important
Timely disclosure of the error
Truth and transparency
Clear explanation of what happened and why
Explanation of how the consequences of the adverse events will be addressed (medical treatment, etc.)
Assurance that steps have been/will be taken to prevent the error from happening again
Emotional support including an apology

5. Why is Disclosure so Difficult?
Traditional approach is conservative; we are usually reluctant to
apologize or admit error
Therefore, it is a skill set that must be learned
Fear of the patient or family response
Lack of support & agreement among all caregivers

6. Structure of a Successful Disclosure Program
Event
Initial Disclosure
Say I’m sorry
Disclose only what you know to be true. You can’t un-ring the bell
Explain any immediate actions that have been taken to protect or treat the patient
Investigation
Keep patients/families informed
Investigations don’t have to be complete for periodic updates

7. Structure of a Successful Disclosure Program
Disclosure/Apology
Preparation
Review the facts
Designate a spokesperson and disclosure team
Select an appropriate setting
The Conversation/Disclosure
Simply describe what happened
State the facts
Say “I’m Sorry”
Establish a plan for follow up
Resolution
Provide the opportunity for closure