Are We Making Disclosure & Apology/CRP Programs Too Difficult?
For loyal readers of Sorry Works, I am sorry I have been radio silent for the last few months. I have started a new adventure as a high school biology teacher. I have an MS in Biology and MA in Bioethics and wanted to help with our teacher shortage, including working with future doctors, nurses, and other healthcare professionals while they are still in high school! I love my new work. Nonetheless, Sorry Works! is still a priority for me, and will be so as long as there are medical errors that harm patients, families, and medical professionals. I continue to deliver presentations and Sorry Works! online content is always here for you. I pledge to get back in the routine of writing weekly e-newsletters. Thank you for your patience.
Sincerely
- Doug
Doug Wojcieszak, MA, MS
Founder & President
Sorry Works!
618-559-8168
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Are we making disclosure and apology too difficult? Are we overthinking this concept?
Earlier this year (during summer), the Collaborative for Accountability and Improvement offered a webinar addressing why so many disclosure/CRP programs fail. Here is the link. Now, for the record, I have not heard or seen evidence of disclosure programs "failing" because they increased the number of lawsuits or overall litigation expenses. I have, instead, heard of disclosure programs failing to take root for a variety of reasons, including the organization is too busy, too many other priorities, and lack of inspired leadership, as well as the "old" excuses of the trial lawyers will eat us for lunch, etc. It's often a failure of will and follow through.
As I reflect on nearly 20 years of work in this field, I believe we have done a decent job of addressing the old boogie men of "sorry will get us sued" and other irrational fears. I think, however, what is holding us back is the complicated nature of how CRP/disclosure programs are sold and marketed to acute and long-term care organizations. We are told to do disclosure/CRP right, you have to assemble this big team of people, everyone gets new roles, titles, and responsibilities, lots of training and more training, processes for communication put in place, and various other work, etc, etc. And how does the turnover rate in healthcare impact such a complicated process? No wonder many overwhelmed healthcare administrators think disclosure might too big a lift, or something that can be done next year...but "next year" never arrives.
Perhaps we need to return to our roots...and find simplicity?
I think it starts with acknowledging that so many of our problems start -- and can be stopped -- at the bed side with front-line physicians, nurses, and other clinical staff. We need to get these folks to a) build solid relationships pre-event and b) run to problems post-event, sit down, listen, and say "sorry," and then call someone in leadership. This requires training in medical schools and nursing schools, training when new hires come on board, and continually reminding people this stuff is a priority -- which should not be too tough. If we can get to this level, the vast majority of problems that can lead to litigation, complaints to regulatory officials, and/or bad media can be resolved before they even start. When something goes wrong, make sure your people know to sit down, listen, say "sorry," then call leadership. Continually tell your folks to run to problems.
It's also a matter of having enlightened folks in leadership, including the risk, legal, and insurance folks, be pro-active when complaints arise. Hopefully, most cases will be brought to the attention of these folks before litigation ensues. However, for those cases that result in a demand letter or a case being filed, these wise leaders can pick up the phone and call PI counsel and have a conversation (yes, your organization can have adult conversations with PI attorneys). More importantly, these enlightened executives should be pro-active with local PI counsel and let them know you want to be transparent when things go wrong and work with patients, families, and their counsel. Let the PI attorneys know the door is always open, you will resolve legitimate complaints fairly and quickly, but don't bother us with bogus demands.
Disclosure and apology should not be complicated. Just change the narrative post-event. It's common sense, and good business sense too. Let's not overthink this....
Sincerely,
- Doug
Doug Wojcieszak, MA, MS
Founder and President
Sorry Works!
618-559-8168 (direct dial)