'Sorry' isn't a word overheard
very often in the wards of Canada's hospitals, says
the head of the Canadian Patient Safety Institute (CPSI),
Philip Hassen. But it should be.
A former hospital CEO, Mr Hassen
has often seen patients injured by adverse events litigate
simply because they weren't properly informed by doctors
about what happened. So, on March 18, the CPSI launched
the first-ever set of national guidelines instructing
physicians on how to properly talk to patients and their
families about adverse events.
Mr Hassen believes the document
will ease the worries of caregivers stuck in an environment
that doesn't allow them to express regret. "You're not
seen as a good doctor if you say 'sorry'," he says.
"Most hospitals don't want their employees to tell patients
more than they have to. And the agenda has been: 'how
do we minimize being called on mistakes?'"
NOT
FAR ENOUGH
The guidelines suggest that a patient should be told
as soon as possible after their medical care has been
compromised, and that this should include a plan for
follow-up treatment. Apologies should be made when they
seem warranted after an investigation into the event.
There are those who believe the
document doesn't go far enough. Richard Marks, a malpractice
lawyer working in Ottawa, told Canwest News that he
believes the guidelines should be made a legal obligation.
"There's always a risk that a medical practitioner who
has made a mistake is going to try to hide or is not
going to make any effort to disclose it in order to
protect their own interest," he said.
In turn, Doug Wojciezsak, author
of the apology strategy book Sorry Works!, chastised
the document in a press release for omitting the issue
of compensation. "Canadians took a pass on this issue
because even though healthcare is provided by the government,
compensation for injured patients/families is not,"
he wrote. Mr Wojciezsak proposes hospitals approach
their medical liability insurers with this question:
"Would you be interested in partnering with us to develop
a program which will reduce frequency and severity of
claims while increasing patient safety?"
SMALL
STEPS
Mr Wojciezsak did, however, compliment the guidelines
as a good first step which may, with additional work,
become a model for disclosure programs around the world.
Many provinces, including Alberta,
BC and Nova Scotia, have already made efforts to promote
disclosure by bringing out their own guidelines. Some
of them have also gone the extra mile and legally protected
apologies; in early February, Manitoba followed Saskatchewan
and BC by ratifying its own Apology Act.
"What these guidelines try to do
is give everyone a consistent framework to lay out policies,"
stresses Mr Hassen. "Caregivers want to do this and
it engages the provinces in what needs to happen. Every
physician and nurse is ethically bound to disclose.
They should not be penalized for doing so. What we need
is protection."
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