New Study on Disclosure --- and some old thoughts
Last week a study was released in the journal Medical Education basically saying that we should look to the social psychology literature for thoughts and ideas to bolster disclosure training. Here is an excerpt from the study's abstract: "Strategies to overcome these maladaptive cognitive patterns are discussed. The authors note that interactions with standardised patients (SPs) can be used to simulate hospital encounters and help teach important behavioural considerations. Virtual reality is introduced as an immersive, realistic and easily scalable technology that can supplement traditional curricula. Lastly, the authors highlight the importance of establishing a professional standard of competence, potentially by incorporating difficult patient encounters, including disclosure of error, into medical licensing examinations that assess clinical skills." Here is a link to access the study.
We're heard a lot of these thoughts and ideas before: Simulations and role playing...practice makes perfect! And simulations will only become more life-like as technology continues to evolve.
I do like the idea of including disclosure of medical errors into medical licensing examinations, although, some medical students and residents have told me disclosure is already appearing on different tests and examinations.
However, what is missing from this study (and it's an "old" yet very timely idea) is training clinicians about the compensation piece of disclosure. It's not enough to have the compensation piece in place (and many hospitals, nursing homes, and insurers still don't have it yet), but we must educate staff about the role of economic and non-economic compensation. Upfront compensation is a critical part of disclosure, and clinicians can often be part of making amends post-event -- but they have to know about it!
Look at it this way: Many clinicians, including some very prominent physicians who will go un-named, know nothing about the compensation piece! They're clueless....they don't know what lays beyond saying "sorry." That's a major disconnect for me; clinicians are not seeing the entire picture with disclosure which may be impacting their buy-in to the process. Now, educating clinicians about the compensation piece doesn't mean turning them loose to promise the world to patients/families post-event. But, they need to understand how the entire process works, including compensation. Moreover, by understanding the role of compensation in disclosure, physician and nursing leaders can be involved in making amends with the patients and families they know better than the guys in claims.
Sorry Works! presentations provide a complete overview of the disclosure process -- including compensation -- for your staff. To schedule a CME-accredited talk for this fall, call 618-559-8168 or e-mail firstname.lastname@example.org.
Doug Wojcieszak, Founder, Sorry Works!