Preparing to Disclose a Medical Error or Adverse Medical Event

Speaking with patients or their families after a medical error or an adverse medical event is one of the most difficult conversations a clinician can have. Rather than taking a deep breath and walking into this stressful event unprepared, being thoughtful about how the meeting might progress and what the priorities might be is well worth your time. Preparing for a difficult  conversation, in fact, can greatly support the interactions between the patient and clinical team and help to reduce the anxiety felt by all. Here are some tips for preparing to have such a conversation:

Tip 1:  Purpose 

Remember that the meeting with the patient and family is for their benefit.

Tip 2: Team Members

Determine which clinician/provider(s) should be present for the initial conversation and assess who should be available to support the patient and family.

Tip 3: Present a Unified Voice

Before meeting with the patient or family, discuss the need for the team to present themselves in a sincere, unified, and professional manner. This is not the time for the team members to debate about the event.

Tip 4:  Avoid Blame

Avoid blaming others. For example, saying, “the lab always does this,” or blaming the system.

Tip 5:  Be Honest

Think about what you will say to the patient or family about what has happened. Honestly share the facts of the situation, as they are known, with the patient and family. But, resist the temptation to speculate beyond what you know for certain at this point.

Tip 6:  Try to Anticipate the Patient or Family’s Needs

Anticipating the patient’s and family’s needs and being prepared ahead of time, even practicing the conversation in role play, can be very helpful. Speak with an institutional coach or other resource and the team beforehand to anticipate potential questions and emotional reactions from the patient and family and how you might respond.

These tips are based on the “Guidelines and Tips for Disclosure and Apology Conversations” video narrated by Dr. Elaine Meyer in collaboration with OpenPediatrics

These tips are based on CRICO’s “Guidelines for Disclosure.”

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