When Medical Errors Happen, Executives Shouldn't Hide

Cheryl Clark, for HealthLeaders Media, November 2, 2011

Hospitals and healthcare organizations have a choice. They can "continue to go into defensive, reactive, survival mode or to go into proactive, learning, developmental mode," the report says.

Conway elaborates: Quite often, when he has spoken with families, loved ones, and patients who were harmed by a hospital adverse event, "they tell us that the reason they sued was because of the way they were treated, and the distance that developed in the aftermath of that adverse event."

"What we're seeing around the country is that organizations get so consumed by this discussion about whether or not [the tragic result] was preventable, and the family is not being supported, and they're getting angrier and angrier and angrier. Then all of a sudden you have someone who is dramatically more likely to sue."

The staff is often a second victim of the hospital's overall response, Conway says. Avoidant postures after an adverse event are sure to perpetuate a lack of trust that can tear apart not just the organization and its staff, but also the reputations they've built over time.

In the latest edition of the report, Conway and co-authors offer a series of checklists, questions, and elements to better prepare hospitals to respond to adverse events. It contains several case studies of the proper way for a hospital CEO to phrase regrets.

For example, Paul Wiles, CEO of Novant Health in Winston-Salem, NC, says that after MRSA-related deaths in his neonatal ICU, "I am accountable for those unnecessary deaths in our ICU. It's my responsibility to establish a culture of safety. Up until the time I read the documents about the young mother's loss of her newborn son, I had been unintentionally relinquishing that duty—in effect delegating it to others without letting them know they had a responsibility to perform.

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