‘I’m sorry’: Two words that can avoid a lawsuit
November 3, 2009 by Carol KatarskyPosted in: Communication, Ethics, Health care/Treatment trends, Hospital Management, Human Resources/Staff management, Patient/Client Communication, Special Report
When an inevitable medical error takes place, few health care providers want to admit to a patient — or the surviving family — that they screwed up. But that just might be the smartest thing they can do.
Some hospitals have realized that by being open and upfront from the moment the mistake is discovered can not only reduce the chances of a lawsuit, it also helps restore trust sooner.
More importantly, in the long run, open communication helps the hospital or practice become safer by learning from past mistakes — and how to prevent them in the future.
Road-tested theory
In 2004, the University of Illinois set up a special department to work with patients and their families who had been affected by medical errors. Among the service’s policies: full disclosure of medical errors as well as offering an apology and compensation to the patient/family.
In addition, affected patients and/or family members were invited to work with a hospital board that oversaw plans for reducing the incidence of medical errors.
Although some thought admitting fault and giving patients a glimpse at the inner workings of the hospital might be asking for trouble, the long-term results are quite different.
Since the new service launched, lawsuits against the hospital are down 40% — even though the number or procedures has increased 23%.
The program also led the hospital to get feedback on the effectiveness of various safety programs, and to make improvements as needed.
Risk vs. reward
Getting medical staff to go along with such a program might not be easy. Few of us like to admit we’re wrong even for something as small as having forgotten a deadline on some paperwork. When faced with admitting they made a mistake that cost someone the use of a limb — or their life — it’s understandable that staffers may balk.
But staffers are human, and even the best will make mistakes. It may be worth reminding them that without open communication about the errors that do happen, there’s no way to prevent more of them from happening in the future.
Do you think a “full disclosure” policy is the way to handle medical errors? Let us hear your experiences in the comments.
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Tags: apology, Communication, lawsuit, medical error, safety, University of Illinois
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November 4th, 2009 at 6:34 pm
Three years ago I was admitted to a top Boston hospital. Bottom line the doctor waited too long to perform necessary surgery which resulted in a burst colon and major complications. The doctor who was a warm straight forward communicator who told me that he waited too long because he mistakenly thought my problem was Krohn’s Disease or Cancer that would have required a different procedure. he apologized for the error and told me there was a hospital wide conference and investigation about his mistake. I did not sue.
I felt medical practice is not a perfect science and he was not negligent. ,,, just human. Friends encouraged me to sue who witnessed my suffering – three surgeries alot pain and my losing my job.
I agree with the findings of the University of Illinois
November 5th, 2009 at 11:17 am
This happened about 8 years ago in a non-profit hospital. A very seriously ill 57-year-old heart attack victim (ARDS was present as well) was being given a bath on the night shift by an experienced RN and two New Grad RNs. The experienced RN turned off the alarms on the monitor as she wanted to talk to them about the patient. Sometime during the bath the bed moved and inadvertently knocked the plug out of the wall for the ventilator. This went unnoticed and, since the alarms were not on, the first warning of something wrong came from a frustrated monitor tech yelling at them about what was going on – he had watched as the patient’s oxygen level and then HR deteriorated. He hadn’t notified them earlier because there were 3 nurses in the room and he knew the rule about not turning off alarms – he thought they were working on her. When the nurses in the room looked up the patient was without a heart beat – asystole. Despite resuscitation attempts, the patient died.
The family was called immediately and when they arrived the charge nurse and the physician sat them down and explained what happened. I’m not sure if it was because the patient was not expected to live or that the hospital admitted the mistake and apologized but the family did not bring suit. I use this example in every Nursing Orientation class I have – I strongly feel that it was because of our honesty and sincere apology that the family didn’t pursue a lawsuit.
To complete the story, we had to decide whether to keep all 3 nurses or fire all three nurses. While I felt the seasoned nurse made many bad decisions and was not willing to take the blame for anything that happened that night, the option to discipline wasn’t granted. I left shortly after and do not know how she fared. The 2 new grads, however, were at the beginning of a very promising career (and became exceptional nurses) so we opted for intensive education. This was a lesson I have never forgotten – we are all human and we all make mistakes.
November 5th, 2009 at 12:35 pm
It is good to see an article that suggests collaboration with the patient. A few years ago, I was working in a medical group and had the duties of risk management. A patient’s wife called me with a complaint about the way her husband was treated in the hospital. I listened intently to her story, unsure of where she was going. The group I worked for was hospital based and rarely had direct patient contact. By the time the woman reached the end of the story, she was sobbing and saying that the surgeon had operated on the wrong area. I asked how her husband was healing and coping and told her that I was truly sorry for her experience. She then said something that has stuck with me; “if only the doctor would have said he was sorry, I would never consider suing him”. She did not bring our group into the litigation. I received a note from her thanking me for listening with empathy. Good job UI!
November 7th, 2009 at 12:51 am
@Paula: Thanks so much for sharing a patient’s perspective! It’s my personal belief that direct-and-honest is the way to go in these situations. Of course, that’s also much easier to say when you’re not the one in the hot seat.
I agree that medicine is part art as well as science, and the best providers will sometimes make a seemingly “dumb” error. Being able to talk about it and explain what happened can help give everyone involved more perspective.