What to tell patients when things go wrong (Part 2 of 2)

Posted on by CDC's Safe Healthcare Blog
Abbigail Tumpey, MPH CHES
Abbigail Tumpey, MPH CHES

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:

  1. Empathy and caring
  2. Honesty and openness
  3. Dedication and commitment
  4. 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.
Sue Hanlon, Evelyn McKnight, and Abbigail Tumpey
Sue Hanlon, Evelyn McKnight, and Abbigail Tumpey

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.

Posted on by CDC's Safe Healthcare Blog

4 comments on “What to tell patients when things go wrong (Part 2 of 2)”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    Excellent summary of the strategies that should be employed following the exposure of patients to healthcare-associated infections. I recommend adding one more to the list: Establish an easy way for the public to obtain information and express (angry) feedback. Some patients will be unable to move on from the incident until they have had the opportunity to verbally punish the facility that was responsible.

    I agree with your comments. Empathy, compassion and expertise are important attributes to be exhibited when one is in process of reversing an adverse event that has occurred to a patient during a medical visit/procedure. Listining to the patient and expressing deep regret, and conveying a sincere meaculpa, can help alleviate many problems.

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Page last reviewed: July 20, 2015
Page last updated: July 20, 2015