Disclosure and EMR: Alerting "Downstream" Staff
Last week I was in a discussion with the leadership of a hospital about their disclosure program, and EMR came up during our meeting. Specifically, the person who raised the point said it is not uncommon for an event to happen "six shifts ago" or in another part of the hospital, disclosure and empathy takes place, BUT, then the staff downstream of the event & disclosure doesn't know what happened. This can be especially problematic when the "downstream" staff are asked questions by the patient or a family member, or even confronted in a hostile fashion. When caught flat-footed it's too easy for staff to duck questions and look like they are covering up, which can anger the family and undo the disclosure process. Instead, staff need to be alerted so they can empathize: "Mrs. Smith I am sorry to hear what happened, and we look forward to hearing what the review has to say. In the meantime, how can I help you right now?" The thought was developed during the discussion that as EMR systems evolve some "flags" be put on the system to quickly and easily alert staff of unhappy patients/families and that disclosure had been done. I think it's a really good idea. Hospitals are crazy, busy places, and not everyone is on the same page or has heard "the news".....so this is a way to get people on the same page when it matters most. In addition, when disclosure happens basic documentation needs to happen, and your EMR system needs to be able to accommodate this.
Another idea in this realm is a much more "low tech" concept from a hospital in Oklahoma where they put a vase of artificial flowers in the rooms of patients who have experienced adverse events or even significant service lapses. The family has no idea why the flowers were put in the room, but to everybody on staff, from the docs to the janitors, this is the "high sign" a relationship needs to be recovered. I think this is especially important because many times staff members can have bad days, either for professional or personal reasons, and the flowers are a subtle way to say check your unhappy face at the door.
Remember, Sorry Works! provides disclosure consulting on a variety of issues, from specific cases to your disclosure policy -- click this link to learn more.