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