A few years ago, perhaps subsequent to language in the healthcare reform law and new emphasis on patient-centeredness and patient safety, acute care organizations "began to embrace the concept of being transparent, but were still struggling with its application. They had a commitment to being open, but the actual change we were seeing on the ground was, well, limited," he says.
Big Changes Coming
But the culture of disclosure is changing.
"We are really starting to see a transformation underway in terms of how healthcare institutions and malpractice insurers think about the response to a patient and their families after a medical injury," Gallagher says.
There are discussions in which providers now think it's right to use the word "apologize" or say "I'm sorry," and that evidence such words don't exacerbate litigation. On the contrary, if anger is what prompts litigation, then soothing that anger might thwart these issues going to the courts.
Now the culture is shifting from silence and ignorance to conversation, dialogue, and discovery. And in talking with experts, I've discovered seven ways hospitals and doctors are working together to be more forthcoming about adverse outcomes, even before they know whether someone was at fault.
1. Disclosure Coaches
"Disclosure Coaches" are cropping up in hospitals across the country, from Brigham and Women's Hospital in Boston to Oregon's Patient Safety Commission.
These are nurses, lawyers, risk managers, or social workers or other physicians. They aren't the ones who have the conversations with the patient and family about the bad outcome.