What to tell patients when things go wrong (Part 2 of 2)Posted on by
Author – Abbigail Tumpey, MPH CHES
Associate Director for Communications Science
CDC, Division of Healthcare Quality Promotion
In my last blog, I discussed some of the emotions that patients may feel when they are notified that they were potentially exposed to an infectious disease during medical care – fear, anxiety, anger, loss of trust, and lack of control. Given this mix of strong emotions, how does a healthcare facility representative break the bad news to a patient? How do you balance being transparent and with retaining the trust of your patients? The answer is in proven risk communication concepts that ensure we address patients’ concerns and feelings, while giving them the ability to take back control of the situation (and their health and healthcare).
Risk or crisis communication literature identifies four factors that determine whether the public will perceive a messenger as trusted and credible. To maintain trust, a healthcare facility representative must express:
- Empathy and caring
- Honesty and openness
- Dedication and commitment
- Competence and expertise
For example, a spokesperson could say, “We realize that you turn to Dr. Smith’s Medical facility to get better. This event is intolerable to us as well, and we want to work with you to resolve the situation and ensure your safety and well-being. We are taking steps to ensure that this event never occurs again in our facility.” Then, the healthcare facility needs to follow through on these steps and work to prevent such incidents in the future.
Some effective risk communication strategies to keep in mind during a patient notification include:
- Acknowledge the situation and any uncertainty. Taking responsibility is key to retaining trust. In addition, if you don’t acknowledge the situation, people will think you are not aware and then they will start rumors. Honestly admit when information is not known. Explain what you are doing to learn more and provide a timeframe for updates.
- Acknowledge people’s emotions. Patients may feel fearful and angered by the situation. Be empathetic and apologetic. Send the message that you are working to provide any support needed to affected patients.
- Ensure transparency. Be honest, frank, and open. Give anticipatory guidance on how you are working to investigate and prevent the situation from occurring again. Emphasize that a process is in place to learn more.
- Communicate compassionately. Express wishes, such as, “I wish our answers were more definitive.”
- Don’t over-reassure. Overconfidence or over-reassurance makes the credibility hole deeper. Be as clear and as accurate as possible regarding the risk.
- Set up accountability mechanisms. Let people know what you will do to address the issue and how and when you will report progress.
- Forecast new or emerging problems on the horizon. Anticipate future patient safety challenges and how you are going to address them. Be willing to address the “what if” questions.
This past weekend, at the APIC Annual Conference, I gave a workshop on this issue with two of my colleagues – Evelyn McKnight, a patient who was infected with hepatitis during an unsafe injection practice, and Sue Hanlon, a risk manager from a major medical center in Colorado who has handled a large-scale patient notification. We discussed how you can be transparent in healthcare and still build and retain the trust of your patients.
As always, we would like to hear from you about how we can improve the way in which we communicate to patients about infections and medical errors. Please leave your comments below.