When Medical Errors Happen, Executives Shouldn't Hide

Cheryl Clark, November 2, 2011

When a provider makes a tragic mistake that harms a patient, most healthcare organization executives and their staffs are told to hide.  If they say anything, they will be more likely to be sued, they think.

Instead of promptly reaching out to empathize and console with food, housing, money, and social support for those whose lives are irreversibly altered, hospital executives and staff often take a "willful blindness" posture.

They don't acknowledge, disclose, or apologize. Instead, they repeat phrases like, "It will blow over," "It wasn't our fault," or "No one will find out."

They advise care teams to act defensively, to avoid saying anything that will expose them "to the media."  They think "I'll look bad," and tell everyone "I'm unavailable." Or "Our attorneys will handle it."

But these phrases, attitudes, and behaviors are just the ones that will make litigation more likely and prolonged, with potentially higher damages and more animosity, says James Conway, senior vice president for the Institute for Healthcare Improvement. And these responses can add more anxiety and suffering to the affected patients and their families.

In the 2011 edition of his 2010 white paper, "Respectful Management of Serious Clinical Adverse Events," released late last month, Conway and three co-authors explain their year-long research and case studies in which hospital officials have used the above phrases to try to escape blame for an adverse event. And they reveal that when hospital systems have tried new strategies to reach out instead of run for cover, the situation dramatically improves.

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