Adverse Event Aftermath: Departments are creating programs to help physicians cope

So how can individual doctors and otolaryngology departments or practices make sure they’re offering, and getting, the support they need after an adverse event?

Dr. Shah offered the following tips:

1. Be overly pessimistic every day, although that may seem counterintuitive in a profession focused on optimism. “Be preoccupied with failure,” Dr. Shah said. “I’m a high-volume surgeon doing 700 surgeries every year, and before each one, I think ‘What could go wrong?’”
2. Realize that errors do occur. “Start with the premise that ‘yes, I can understand how this can happen, let me see how I can mitigate it in my practice,’” Dr. Shah said.
3. Have a clearly stated position on disclosure and apology. Individual physicians should know those positions and should call their hospital’s risk manager or legal counselor immediately after an adverse event.
4. Have a regular peer-to-peer discussion of adverse events within the practice. If you don’t have a system, members can always call the American Academy of Otolaryngology-Head and Neck Surgery, according to Dr. Shah, who is co-chair of the Academy’s patient safety committee. “We’re always available to provide guidance,” he said.

Another resource is the disclosure chapter of the University of Michigan’s “Patient Safety Toolkit,” which includes step-by-step guidance on how and when to disclose errors (med.umich.edu/patientsafetytoolkit/disclosure.htm). The “Sorry Works” coalition (sorryworks.net) also offers disclosure booklets, tip cards, guidelines and PowerPoint presentations.

According to Dr. Shapiro, the ability to talk about medical errors is vital to the practice of good medicine. “One of the biggest morale busters at most institutions is the sense people have of not being fully valued or respected,” she said. “Support after an adverse event is a key part of valuing your clinicians. The more people feel trusted, respected and valued, the better work they can do taking care of patients.”