Michigan Model: Apology, Different Question, or Both?
Over the last month an article from Korea Biomedical Review authored by Mr. Kim Hoh has made the rounds on LinkedIn and other platforms. Kim Hoh is a friend and supporter of disclosure and apology. The article was developed from Hoh's interview with Mr. Rick Boothman, architect of the Michigan disclosure program, and is entitled, "It wasn't about the apology; it was about asking a different question." Here is the link for the article: http://www.koreabiomed.com/news/articleView.html?idxno=6703.
First, this is an important article and valuable reading for everyone who cares about the disclosure movement. Hoh does an excellent job teasing out important elements of the Michigan disclosure program, most especially how the University's novel approach to assessing risk is anchored in a simple, straight forward question: "Are we proud of this care?"
In the aftermath of an adverse event, the Michigan disclosure program leaders (heavily laden with clinical professionals) assess the care in question and ask if the institution is proud of the care, not "Can we win this case?" or "Can we find an expert to justify our choices?" or "Should we wait to see if the family pursues this matter?" How radical! If the Michigan leaders are not proud of their care they quickly meet with the patient/family, evaluate needs (financial and otherwise), and move forward with their disclosure process.
Other factors identified in Hoh's article include Michigan assigning a point person to impacted families, and quickly determining needs and desires. If a family wants to meet a pathologist to discuss the care, Michigan schedules a meeting with the pathologist. This is important stuff....how often do families feel abandoned post-event, and/or run into road blocks when requesting basic information or meetings with certain personnel?
For those who want to gain some valuable information for their disclosure programs, the Hoh article is a must read. The "are we proud of this care?" question is a paradigm shift in healthcare risk management.
I will, however, make one critique of Hoh's article. As you can guess by the title, Hoh opines that apology is not as critical a factor in the Michigan disclosure process as the "are we proud" question. I respectfully disagree...I think apology is as important as any other element of the Michigan program. Yes, the "are we proud" question is radically unique and can lead to more authentic conversations with patients/families, but apology is often the gold standard for grieving patients/families. In fact, many of us families who have experienced medical error often say the apology is the most important element of any post-event discussions. Some families can forgive poor care so long as someone offers a genuine apology.
Kim Hoh wrote an important and valuable article, I appreciate his contribution, and he is a friend to the disclosure movement. I am not criticizing him. I just want readers of his article to keep all disclosure elements in mind -- apologies included -- as they develop and refine their disclosure programs.
Remember to check out our recently released Just-in-Time Disclosure Tips and share them with your colleagues.
Have a great weekend!
- Doug
Doug Wojcieszak, Founder and President
Sorry Works!
618-559-8168 (direct dial)
doug@sorryworks.net