Supporting Safer Healthcare

“Your child was harmed while under my care, by a mistake that I made, and I am so sorry.” 

How would it feel to hear those words?  How would it feel to say those words?  How would you help coach a healthcare professional who was about to face that conversation?

I had the opportunity to explore all of those roles recently and let me assure you, none of them were comfortable or easy.  And in my case the scenes were scripted, not real.  

A few weeks ago I participated in a week-long training session on conflict management skills for health care professionals run by Carole Houk, JD, LLM, principle of Carole Houk International.  After several days of in-depth training and discussion around building an environment that supports transparency in healthcare, members of the group were each given different roles to play in various case scenarios.  Each player received only the facts of the case that were known to their character.

At one point I played a grieving parent; I was surprised to find that it was difficult to listen to and comprehend the information that was being shared by the “doctor” in the scene. I sat there thinking about all the things I ”knew” about the child I’d just lost. Just playing that difficult role gave me added compassion for real parents, real patients, and real physicians undertaking the challenging role of disclosure.  

We had been extensively coached by Carole and her assistant, Leigh Ana Amerson, prior to these role play sessions.  Among other points we were reminded to use the patient’s personal name. Don’t refer to them as the patient, your child, your husband, etc.  Using the patient’s personal name reassures their loved ones that you see them as a real person, not just another case. 

One of the repeated reminders we heard was the need to allow the person receiving the disclosure time to express their feelings and to talk about their loved one.  Speaking for myself, I know that I nodded and agreed, all the while thinking that was pretty much a “no brainer.”  However, in each scene we played, those of us given the role of disclosing, or coaching the discloser, were so anxious to “help” that we usually jumped in with some information or offer long before we’d allowed sufficient time for the patient or family members to have their say.  Listening to and acknowledging painful emotions is distressing.  

It was excellent training for a difficult skill.  Those of us who attended are continuing to practice, realizing that disclosure and conflict resolution done well require life-long learning.  

Carole and Leigh Ana