Disclosure and Apology in Radiology

radiology-disclosure-apology
radiology-medical-error
Radiology adverse event

An error in care. A missed or delayed diagnosis.  Are you prepared to disclose these to your patients?

Until recently, many patients never met their radiologist to hear about these highly charged clinical events. That’s changing. Today’s patients want to talk with you and your radiology team.

Disclosure and apology conversations after medical error are among the most difficult in healthcare. Patients and families may be expressing anger, frustration, and sadness. They may expect their clinicians to take responsibility and convey empathy – even as many radiology teams have no consistent approach to such situations, causing clinicians to often feel defensive, ashamed, unsupported, and unprepared.

Navigating the aftermath of a medical error requires specific skills and preparation. Your team needs to establish an internal communication process leading up to the disclosure conversation with patients and families. At the same time, individual clinicians need skills to prepare for these conversations while engaging confidently and compassionately.

This new online workshop, designed BY radiologists specifically FOR radiologists, will outline the ethical underpinnings, legal and risk management perspectives, important recent developments, and nationally recommended best practice standards around error disclosure. Highly recommended for radiology department/team leaders, training managers, and risk managers (both practice- and insurer-based) as well as individual clinicians.

What radiology professionals will learn:

  • The basic ethical, legal, and risk management principles, barriers, and challenges specific to radiology, through case-based discussion;
  • What an internal communication process should look like, to prepare for disclosure conversations with patients and families, through review of best practices and models;
  • Skills for approaching the conversation, anticipating responses and emotions, and re-establishing a positive relationship for next steps in care.

Who should attend

  • Radiology department and team managers
  • Quality & Safety leaders
  • Training managers, including those responsible for meeting ACGME guidelines
  • Radiology physicians, residents and fellows
  • Nurses and nurse practitioners
  • Physician assistants
  • Technologists
  • Patient advocates
  • Risk managers, including at insurers

Live, moderated online workshop format

Participation in the 2-hour online workshop is through an online video conferencing platform. After opening case-based discussion, we’ll view and discuss three short films illustrating relevant scenarios: a team’s deliberations in the aftermath of a delayed diagnosis resulting from errors, the role of a department leader and an institutional disclosure coach, and a radiologist’s discussion with a family about an interpretive error. IPEP is renowned for its use of actors to bring the full range of perspectives into consideration; this scenario-based format will make nuanced concepts more tangible. Using our interactive platform, including our guided whiteboard and comment-board discussions, you’ll be able to engage directly with IPEP’s faculty and your peers from around the country and the globe to learn, discuss, and practice strategies for disclosure.

Enrollment is capped at 50 participants in order to offer everyone the opportunity for input and questions during discussion and Q&A sessions.

General Information

Upcoming Workshop Dates:

Wednesday, June 26, 2019

9:00-11:00 am, EDT
(6:00-8:00 am PDT)

**REGISTRATION FOR THE 6/26/19 WORKSHOP IS CLOSED**

Tuition:  $50.00

CME/CE Available
2.0 for risk management, MOC credits

 

Resources on Disclosure and Apology

Faculty

Learn from Harvard Medical School experts in radiology, bioethics and communication:

  • Stephen D. Brown, MD, Director, Institute for Professionalism & Ethical Practice, Boston Children’s Hospital; Associate Professor of Radiology, Harvard Medical School; Chair of the Professionalism Committee of the Radiological Society of North America (RSNA).
  • David Browning, MSW, LICSW, Senior Scholar and Co-Founder, Institute for Professionalism and Ethical Practice, Boston Children’s Hospital.
Stephen D. Brown, MD

Director
Associate Professor of Radiology, Harvard Medical School

David Browning, MSW, LICSW

Senior Scholar Emeritus
Psychosocial Faculty
Co-founder, IPEP

Resources

Below are some of the most relevant articles, guidelines, and videos by key thought leaders in the fields of disclosure and apology, bioethics, and medical communication for your review and learning.


Video Gallery

Find video recorded interviews  with national experts covering a wide variety of issues related to Disclosure and Apology, including institutional perspectives and processes, just culture, peer support, and provider and patient perspectives. Hear from Beth Ullem Daly, Dr. Robert Truog, Dr. Jo Shapiro, Dr. Lucian Leape and many more.

View additional videos in our VIDEO GALLERY


Guidelines for Disclosure after an Adverse Event


Read the Guidelines for Disclosure after an Adverse Event
Developed by CRICO in conjunction with the Institute for Professionalism and Ethical Practice


Articles

Key Articles about Apology and Disclosure in Medicine and Radiology

Stepping out further from the shadows: Disclosure of harmful radiologic errors to patients
Brown SD, Lehman CD, Truog RD, Browning DM, Gallagher TH., Radiology 2012; 262:381-386.

Patients’ and Physicians’ Attitudes Regarding the Disclosure of Medical Errors
Gallagher TH, Waterman AD, Ebers AG, Fraser VJ, Levinson W., JAMA. 2003 Feb 26;289(8):1001-7.

Disclosing Harmful Mammography Errors to Patients
Gallagher TH, Cook AJ, Brenner RJ, Carney PA, Miglioretti DL, Geller BM, et al., Radiology 2009 Nov;253(2):443-52.

The Mea Culpa Conundrum
Leonard Berlin, MD, Radiology 2009; 253:284–287

Radiology trainees’ comfort with difficult conversations and attitudes about error disclosure: Effect of a communication skills workshop.
Brown SD, Callahan M, Browning DM, Lebowitz R, Bell SK, Jang J, Meyer EC.  The Journal of the American College of Radiology 2014; 11(8):781-7.

Implementing communication and resolution programs: Lessons learned from the first 200 hospitals
Timothy B McDonald, Melinda Van Niel, Heather Gocke, Journal of Patient Safety and Risk Management, 2018, Vol. 23(2) 73–78.

The Reality of Disclosure Conversations, by Dr. Robert Truog, Director of the Center for Bioethics at Harvard Medical School

RSNA Course

Medicolegal Issues for Radiologists: To Divulge or Not to Divulge: Diagnostic Misses and Errors (2017)

RSNA 2017 Refresher Course on Error Disclosure (free to RSNA members)
Learning objectives:
  • Describe nuances of communicating diagnostic imaging results to patients.
  • Recognize how peer review and error disclosure are interconnected.
  • Weigh risks and benefits of error disclosure in practice.
  • Explain the rationale for direct radiologist-to-patient disclosure of radiological errors.
  • Discuss how to avoid getting into a claim or lawsuit.
  • Discuss the legal assessment of a missed finding.
  • Discuss best practices to protect the peer review process.
  • This enduring material is estimated to take 1 hour to complete.
This educational activity was originally presented at the RSNA 2017 Annual Meeting and Scientific Assembly. This course was sponsored by the RSNA Professionalism Committee.

Continuing Education

In support of improving patient care, Boston Children's Hospital is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for the healthcare team.

Physician

Boston Children’s Hospital designates this live activity for a maximum of  2 AMA PRA Category 1 Credits ™. Physicians should claim only the credit commensurate with the extent of their participation in this activity.

AAPA accepts AMA category 1 credit for the PRA from organizations accredited by ACCME.

Nurses

Boston Children’s Hospital designates this activity for 2 contact hours for nurses. Nurses should claim only the credit commensurate with the extent of their participation in the activity.”