Eliciting the Functional Processes of Apologizing for Errors in Health Care

Prothero, Marie M.; Morse, Janice M.

doi:10.1177/2333393617696686

Cited by 6 publications

(6 citation statements)

References 37 publications

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“…One important strategy is for the nurse to apologize to the person whose care is being interrupted. Previous research has shown providing a full apology to a patient when a medical error occurs restores the relationship and minimized legal ramifications (Prothero & Morse, 2017). Interestingly, very few studies have looked at how apologizing to patients for an error or inconvenience impacts their perception of care.…”

Section: Discussionmentioning

confidence: 99%

Identifying Strategies for the Management of Interruptions for Novice Triage Nurses Using an Online Modified Delphi Method

Johnson

Schumacher

Lee

2021

J of Nursing Scholarship

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Purpose: To use the Delphi Method to identify strategies used by triage nurses to effectively manage interruptions. Design: This study was based on the concepts of Benner's Novice to Expert Model. An online, modified Delphi approach was used to engage triage, education, and operational management experts in generating consensus recommendations on successful strategies to address triage interruptions in the emergency department. Methods and Analysis: A panel of nine triage, education, and operational management experts were selected based on their publication and presentation history. This panel participated in three Delphi rounds, providing individual responses during each round. All responses were entered into a RedCap database, which allowed research team members to synthesize the results and return summaries to the participants. Final consensus was reached among this panel regarding recommendations for successful strategies to address triage interruptions that can be encompassed in a training module. The experts were then asked to identify the best instructional modality for teaching each of the interruption management strategies. Findings: Eight strategies to mitigate the impact of interruptions were identified: (a) ensure nurses understand impact of interruptions; (b) ensure nurses understand consequences of interruptions on cognitive demands of healthcare workers that could influence behavior and lead to errors; (c) apologize to current patient before tending to interruption and give expectation of when you will return; (d) triage the interruption and decide to (i) ignore interruption, (ii) acknowledge, but delay servicing, interruption, or (iii) acknowledge and service interruption, delaying completion of interrupted task; (e) identify urgent communication as anything clinically significant that impacts the patient immediately or requires immediate intervention; (f) use focused questions to clarify whether interruption can wait; (g) redirect nonpriority interruptions; and (h) finish safety-critical task or tasks near completion before tending to an interruption. The Delphi participants recommended the best teaching modality was simulation for six of the strategies. Conclusions: Participants agreed that there are strategies that can be taught to novice triage nurses to mitigate the impact of interruptions. The experts in operations management, emergency nursing, and education agree that creating simulations to teach each of these strategies is an effective way to educate nurses. Clinical Relevance: Interruptions impact the quality of care provided to patients. Training nurses to prevent interruptions and mitigate the impact of interruptions when they occur has the potential to improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Identifying Strategies for the Management of Interruptions for Novice Triage Nurses Using an Online Modified Delphi Method

Johnson

Schumacher

Lee

2021

J of Nursing Scholarship

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“…Written apologies should not replace verbal apologies. 42 Participants had anticipated their justice needs would be met through human connectionto be listened to and heardbut instead found the investigation focused on written facts, truth-finding and accusation. Notwithstanding the technical status of the Commissioner's opinion being, for the most part, legally inconsequential, 5 importance on the authority of the decision due to potential disciplinary action and the impact on reputation and livelihood.…”

Section: Discussionmentioning

confidence: 99%

Health practitioner experience of Health and Disability Commissioner investigations

Wilkinson

Marshall

2021

J. Prim. Health Care

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INTRODUCTIONThe New Zealand Health and Disability Commissioner (HDC) Act 1994 was designed to protect the rights of consumers and provide a fair, simple, speedy, and efficient resolution to complaints. No recent studies have been published about the health practitioner experience of HDC investigations following a patient complaint, and none that include nurses and midwives. AIMTo use a restorative inquiry framework to understand the impacts and needs of health practitioners arising from an event that led to an investigation by the HDC during the last 10 years. METHODSA descriptive qualitative approach was used with data collected using semi-structured interviews with doctors, nurses, and midwives (n = 13). The data were analysed using thematic analysis. RESULTSParticipants worked in primary care, aged care, and services provided by public hospitals. The emotional impacts arising from the event and investigation were profound, with long-lasting effects on participants’ sense of self, reputation, and how, or if, they continued to practice. Participants indicated a need for support from colleagues and employers, a fair and relational investigation process, and a meaningful way of connecting to put things right. DISCUSSIONA shift to a restorative approach whereby people involved in a complaint come together to speak truthfully about what happened and its impact on their lives, offers hope for a process that repairs relationships and improves health services. Restorative approaches clarify accountabilities and could lead to more satisfactory outcomes for all parties. This study contributes to emerging thinking about the use of restorative approaches in health-care contexts.

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“…. " allows us to bring solace to the patient [12]. Some physicians are reticent to use such expressions, perhaps for fear of having them viewed as admissions of error and, as a result, causes for medico-legal reprisals [13].…”

Section: Apologizingmentioning

confidence: 99%

“…Sincere apologies are excellent tools to defuse a crisis and to win back a patient’s sympathy. “I am sorry that…” or “I am sorry for…” allows us to bring solace to the patient [ 12 ]. Some physicians are reticent to use such expressions, perhaps for fear of having them viewed as admissions of error and, as a result, causes for medico-legal reprisals [ 13 ].…”

Section: Principles Of Crisis Managementmentioning

confidence: 99%

The Patient, the Physician, or the Relationship: Who or What Is “Difficult”, Exactly? an Approach for Managing Conflicts between Patients and Physicians

Tanoubi

Cruz-Panesso

Drolet

2021

IJERPH

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It is the patient who consults, often at the last minute, the one you sigh over when you see his or her name on your list, the one who makes you feel powerless, and whom you would like to refer to a colleague. Every practicing physician has experienced being involved in a dialog of the deaf, with a patient refusing physicians’ recommendations, in a therapeutic dead end. Faced with such patients, the physician tries to convey scientific evidence to untangle the situation. When it does not work, he looks for other arguments, raises his voice, and avoids looking the patient in the eyes. When he is out of resources, trying to sound professional, he uses a sentence such as “I understand and respect your beliefs, but I am telling you what I learned in medical school!”. At the same time, his non-verbal behavior betrays more than a hint of irritation. Far from being caricatures, such situations generally result in the physician diagnosing or labeling the patient as “difficult.” This label is affixed on more than one patient in ten, and for all sorts of reasons. How, then, do you re-establish a relationship of trust? Or, even better, how do you avoid such labeling?

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Eliciting the Functional Processes of Apologizing for Errors in Health Care

Cited by 6 publications

References 37 publications

Identifying Strategies for the Management of Interruptions for Novice Triage Nurses Using an Online Modified Delphi Method

Identifying Strategies for the Management of Interruptions for Novice Triage Nurses Using an Online Modified Delphi Method

Health practitioner experience of Health and Disability Commissioner investigations

The Patient, the Physician, or the Relationship: Who or What Is “Difficult”, Exactly? an Approach for Managing Conflicts between Patients and Physicians

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