Definitions

1
Definitions

• Unanticipated outcome
• A consequence of patient care and/or treatment
  that is not a normal risk for a patient of that
  health status e.g., delayed or prolonged
  treatment, injury, diminished capacity.
• Disclosure
• Telling patients important information regarding
  their medical care or condition which affects, or
  has the potential to affect, their well-being,
  and future health-related decisions.

2
Error disclosure is a policy, not a choice

• Ethics
• Regulatory requirements
• The patients right to know

3
Ethics

• The interests of clients must override the
  self-serving interests of professionals. By
  failing to disclose, a health provider is
  conspicuously placing his or her self-interests
  above the patients.
• -John Banja, Ph.D., Associate Professor of
  Clinical Ethics, Emory University
• Situations occasionally occur in which a patient
  suffers significant medical complications that
  may have resulted from the physicians mistake or
  judgment. In these situations, the physician is
  ethically required to inform the patient of all
  the facts necessary to ensure understanding of
  what has occurred.
• -American Medical Association Code of Ethics

4
Regulatory

• JCAHO redisclosure
• The responsible licensed independent practitioner
  (or his or her designee) clearly explains the
  outcome of any treatments or procedures to the
  patient and, when appropriate, the family,
  whenever those outcomes differ significantly from
  the anticipated outcomes.
• -Intent of Standard RI. 1.2.2.

5
Patients right to know

• What do you have to tell a patient?
• What should you tell a patient?
• If you were a patient injured by a medical error,
  what would you want to know?