Two Continents, One Need: How to Reduce Patient Harm and Communicate after Adverse Events
January 30, 2014 at 4:26 PM
Last fall, I had the pleasure and privilege of traveling to two very different places. I was invited to discuss clinician and patient/family support, especially following medical harm. In October, I attended and spoke at a conference that was sponsored by the NHS at Ayrshire & Arran, Scotland. In mid-November, I traveled to Soldotna, Alaska, where I gave several presentations to various groups within Central Peninsula Hospital. I learned the struggles around adverse events are the same, no matter where you live.
The conference in Scotland was titled Realising Wellbeing, and the focus was on supporting clinicians and staff. I spoke along with many experts in the field. The NHS leadership was obviously aware of the importance of supporting staff. But, what struck me was the lack of understanding on how to handle these situations when patient harm occurs. This only confirmed what I had come to realize over the last decade. Organizational leadership needs to provide a clear expectation for how adverse medical events are addressed each and every time. They should also provide the training and necessary resources around communication and support.
The setting was very different in Alaska (the temperature too!) However, the struggles did not differ. Following my talk to the department heads, I received questions like -- “We have the policies, but how do we implement them?”, “How do we decide whether it’s an error or not?”, “How do we train folks?” and “Who else is doing this work?” It became obvious to me that they needed a road map on how to address adverse medical events. They clearly wanted to do the right thing; they were just not sure how to get there. I explained the foundational elements needed to implement a robust communication and support program. At MITSS we have expertise in the support piece and how to pull the moving pieces together. But, they needed more, and I knew exactly where to send them.
I was excited to share about MACRMI and its commitment to the implementation of a Communication, Apology, and Resolution (CARe) program following medical injury. MITSS has been part of the alliance since its inception. One of MACRMI’s major goals is sharing the lessons learned with others to enable implementation of the CARe program at their institution(s). As I travel around the US and to other countries, it’s extremely helpful for me to be able to provide MACRMI resources. I’ve recently heard back the folks from Central Peninsula Hospital, and they were very grateful for the talks I gave and the resources provided.
--Linda Kenney, President and Executive Director, Medically Induced Trauma Support Services
