Greet and paraphrase
I’m Dr XYZ, one of the doctor here at the department…
I understand you are here for the follow up.
Date Gathering
Current & Previous visit: The Four Questions
When were you admitted?
1.Symptoms: What symptoms did you had?
2.Investigations: What sort of tests did they do?
3.Diagnosis: What did they tell you was wrong?
4.Treatment: What sort of treatment did they offer?
Did you improve?
Tell the error:
- Warn: Thank you for answering my questions. I am glad you’re feeling well, unfortunately, I’m here to tell you about something that went wrong regarding your treatment
- Narrate: As we understand, initially (history)…
- Tell the error: Unfortunately, …
- Pt angry - AVE
A acknowledge - See it, Say it: I can see that you’re upset.
V validate- Anyone in your position would feel the same.
E empathy- We should have been more careful I sincerely apologise.
Management
What will be done next for the ERROR? The Five Steps
1. Incident reporting:
Please accept our sincere apology, the hospital will take this sort of incidences very seriously, this will be reported as a significant error, this is a documented event.
2. Investigate:
When an error is reported as a significant, it’ll automatically lead to investigation. The senior people will carry out the investigation and conduct RCAM - Root Cause Analysis Meeting: It’s a part of investigation.
3. Action will be taken:
According to the investigation results we’ll take a necessary action. How do you take action? We’ll take necessary action according to our policy and protocol. We will be open and transparent in terms of finding out what happened and the actions taken, the person responsible will be put forward. Are you able to follow?
4. Offer seniors:
We are expecting a senior person from the department will come and speak to you, in the meantime I’ll also have a talk to my senior about the discussion we had.
5. Patient Advice and Liaison Service (PALS):
If you wish to make a formal complaint, you have the full right to do so. I can get in touch with PALS, they can help you put forward your complain further. Is there anything else you would like to ask at this point? you must offer PLAS: your duty to let them know you have the right to complain. Offer PALS automatically even if patient is satisfied- do not mater patient is asking or not.
What will be done next for the PATIENT?
Extra points:
- We will look into the investigation and find out the root cause what went wrong in that way
- We can prevent similar incidents in the future from taking place
- We will spread the news and raise awareness about this error
- We will try to change the way we operate.