Exploring Healthcare Professionals' Use of Narrative Mediation Approaches to Address Disclosure and Apology in the Aftermath of Medical Errors

Abstract

Despite overwhelming evidence that suggests that patients, families and health care systems benefit from offering appropriate disclosures and apologies to patients and families in the aftermath of medical errors, few health care organizations in the United States invest in consistent systematic training in disclosure and apology. Using a narrative analysis, this paper explores the cultural barriers in the United States health care environment that impede health care providers from engaging in restorative conversations with patients and families when things go wrong. The paper identifies a handful of programs and models that provide disclosure and apology training and argues for the unique contributions of narrative mediation to assist health care professionals to disclose adverse events to patients and families to restore trust.

Disclosing Medical Errors to Patients: Overcoming the Challenge in Clinical Communication

“…This stage of disclosure occurs after the definitive cause of the error and improvements made to prevent harm to other patients. The disclosure team communicates the cause of the medical error to the patient and makes known improvements instituted 46 .…”

Mediation as Toll to Settle Medical Disputes; Indonesian Case

“…In Hongkong itself, Judiciary's Practice Direction requires parties in disputes to participate in meaningful pre-trial mediations to settle their disputes outside the courtroom. Monk, Sinclair and Nelson noted that mediation is the best way to recreate understanding and trust between the patient and healthcare givers on many adverse event or adverse drug reaction [23]. DeAngelo stressed that in many circumstances, where disputes were related to right-to-die, do not resuscitate, living wills, mediation was the best options chosen by the patients and/ or their next to kin [24].…”