Why Saying Sorry Is Important When Communicating About a Harm Event

April 19, 2022
Postoperative complications leave a patient disabled and angry

An orthopedic surgeon performed a right total knee arthroplasty on a 60-year-old man with a history of right knee pain and osteoarthritis. Over the next several weeks postoperatively, the man complained of pain and swelling in his right lower leg and was told to continue ice and elevation. Six weeks after surgery, the man went to his local hospital emergency department where he was diagnosed with a pseudoaneurysm of the popliteal artery. A vascular surgeon was consulted and performed a repair. The man suffered a permanent nerve injury and was unable to return to work. Following the delay in identifying the postoperative complication, the man was angry with the orthopedist for not looking further into his repeated concerns of pain and swelling, and for not apologizing when the pseudoaneurysm was finally discovered by another physician.

Communicating after a harm event: Be prepared for emotions

It’s natural for patients, senior living residents and families to feel confused, scared or angry after a medical incident. Care teams feel those emotions, too. There can be a tendency to shut down out of fear of legal repercussions or simply a sense of being overwhelmed. Additionally, if those affected by the incident are not getting answers, they may feel their clinicians and care team are hiding something. Care teams may also lose confidence  in their colleagues if issues aren’t addressed quickly, honestly and with empathy for all parties.

Sometimes clinicians will glaze over the emotional experience and focus on the medical facts and getting the patient or resident “better,” when there is the emotional component of a harm event that needs to be addressed. While communicating the current medical condition of the patient is an essential part of the conversation, it is also important to address the emotional toll harm events take on patients, residents and family members. Fear of litigation can also make clinicians feel they shouldn’t speak or apologize.

Why saying “I’m sorry” may help to rebuild trust

Medical professionals whose training emphasizes facts, logic and science may want to lean on pure information as they talk with patients, residents and families. But after a harm event, what most people really want to hear is “I’m sorry.” Saying it can begin to build trust, not only with patients, residents and families, but also among care team members. It affirms to them that transparency and honesty are valued in the organization.

“There is no detriment to being compassionate and empathetic in these harm event discussions. Apologizing is key.”

Traci Poore, Constellation Sr. Risk Consultant

Acknowledging and validating their emotions is also important. By acknowledging and validating emotions, patients, residents and family members feel heard and valued. When communicating about harm events, be sure to allow the patient, resident and family time to express their emotions and concerns. Listen more than you speak and be aware of defensive body posture that can be reflexive on the part of clinicians and care teams. Care teams should be careful not to fall into common traps by saying things like, “I understand how you feel” or “I know what you’re going through.”

HEAL communication training program

Constellation’s new HEAL communication training program provides the opportunity for care teams to practice delivering difficult information about a harm event with care and compassion. The training involves a series of role-playing exercises aimed at providing an interactive, hands-on experience for participants reflective of real-life situations. The role-playing shows how to put new communication skills into use that without practice can be difficult to do. These new communication skills will do even more to build trust and maintain relationships among everyone involved when harm events occur.

The HEAL Prepare Toolkit

Constellation’s HEAL Prepare Toolkit will help assess your team’s readiness to communicate following a harm event and then help you get to best practices. The Toolkit includes a unit on communicating after harm events and contains assessments, best practices, sample tools and coaching. 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) communicating after harm events, and (4) moving forward. Sign in to 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.

Constellation® and HEAL® are trademarks of Constellation, Inc.


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