How to Improve Fact-Finding after a Harm Event Using Cognitive Interviewing

The five components

Cognitive interviewing follows a flexible order of components to enhance the effectiveness of the technique. Interviewers should accommodate and tailor the order of components based on the needs of each witness.

1. Introduction
2. Open-ended narration
3. Probing memory
4. Reviewing the interview
5. Closing the interview

Preparing for the interview

How the interviewer conducts themselves will affect the interviewee’s ability and willingness to share information. It is important that the interviewer prepare for the cognitive interview by:

• Reviewing the timeline/sequence of events to ensure there are no gaps in the initial understanding of the event
• Developing a list of team members to be interviewed (reverse order of involvement)
• Identifying the care processes involved (process mapping), the physical setting and any key documentation surrounding the event
• Reviewing policies and procedures, logs, department documents, schedules, assignments and equipment logs that pertain to the event
• Writing down questions ahead of time

How to improve fact-finding after a harm event using cognitive interviewing

• Develop a team of skilled interviewers. Developing cognitive interviewing skills takes practice. It is not enough to simply memorize the principles. This means one must be efficient at applying the techniques and principles automatically without having to think consciously during the interview about what to do next. Excellent interview skills promote a consistent, streamlined and unbiased process for all involved. 
• Schedule short learning sessions dividing trainees into each of the five components of the cognitive interviewing process. This method will provide a more efficient learning process rather than longer sessions.
• Set the scene. Create a harm event or story for practice. This can be a real or imaginary event. Remember, a practice session has a different mental process compared to an actual event that was observed. Divide the trainees into groups of three—the interviewer, the witness/interviewee and an observer.
• Provide practice time. Ask the group(s) to review their “event”, then allow a brief period for them to practice an individual component. When completed, conduct a debriefing with the group and discuss techniques that were effective and those that need more practice. Inform the trainees that each session will include the component they practiced as well as the next component of the cognitive interviewing process until they have mastered all five components.

Improving and learning after a harm event with the HEAL Prepare Toolkit

“Our HEAL Prepare Toolkit helps your organization prepare for harm events so you can respond quickly and effectively. The Toolkit includes a unit on event response that contains assessments, cognitive interviewing best practices, sample tools and coaching”

Brenda Krzyzanowski, Senior Risk Consultant at Constellation

Start your journey by taking the HEAL Assessment and then the Action Plan will guide you through the Toolkit’s four units: (1) culture, (2) event response, (3) patient communication, and (4) moving forward.

Sign in or register at ConstellationMutual.com to access the HEAL Prepare Toolkit found in Risk Resources.

Constellation’s HEAL program provides healing benefits for care teams and their organizations because we truly believe that what’s good for care teams is good for business.

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