Additional Critique on Disclosure Policies - Confusion Over Admitting Fault

In reading and reviewing several disclosure policies from around the United States, I am starting to see an issue/theme constantly pop up that I find a little bit troubling – but very fixable.   The theme I am referring to relates to wording often seen in policies that reads something like this: "We will apologize without admitting fault."

"Staff may discuss the error with the patient or family, but do not take responsibility."

"We will empathize without assigning blame."

I totally understand why the policies are worded this way.  I really do.  After years and years of deny and defend, risk managers and defense counsel are rightly concerned that the advent of disclosure will result in a flood of clinicians running out to patients and families saying, "We screwed up, we killed your Mom," when maybe the event was simply a known complication...and that's no good for anyone, especially patients/families who will forever believe you killed Mom.  No good.

However, I genuinely worry that the way some of these policies are worded and presented will create confusion with clinicians: I thought we were supposed to own our mistakes?  Be responsible?  I also worry that the wording of these policies may lead to "snow jobs," where patients and families are showered with empathy and customer service post-event, but, ultimately, no one takes responsibility for an error.   Also not good.

So, at Sorry Works! we have always approached this topic in the following manner: "Be quick with the empathy and customer service post-event, but PAUSE before admitting fault to let the review determine if a mistake happened with causation to the event."  I think it's important to link these two strategies in the same sentence so clinicians can see we may be eventually admitting fault for events...but only after a review has determined fault.  Feel free to use our wording in your policies.

It's all in the presentation of the concept....we just need to be mindful of this reality.

Sincerely,

- Doug

Doug Wojcieszak, Sorry Works! Founder, 618-559-8168