Disclosure of Unanticipated Outcomes
June 17, 2022
Reading time: 4 minutes
Unanticipated outcomes1 that occur in the healthcare system can cause physical and psychological
harm to patients, their families, and healthcare providers and staff. However, disclosure of
unanticipated outcomes — when properly performed — can lessen the negative consequences.
Addressing these outcomes with honesty and transparency is not only part of a well-defined disclosure
process, but also an integral step in providing patient-centered care. To prepare for the disclosure
process, healthcare organizations should develop clear policies/protocols and train their providers and
staff accordingly. This checklist can help healthcare organizations assess various aspects of their
disclosure policies and identify improvement opportunities.
|Does your healthcare organization have a written disclosure policy that complies with state laws and professional guidance related to the disclosure process?
|Do healthcare providers and staff receive training on your healthcare organization’s disclosure policy and process?
|Does your healthcare organization consider conducting role-playing or simulation exercises to offer healthcare providers and staff hands-on disclosure training?
|Are healthcare providers and staff educated about the difference between an apology and an admission of liability?
|Has your healthcare organization established a threshold for situations requiring disclosure?
|Does your healthcare organization gather information about the unanticipated outcome from providers and staff who were involved and from a formal investigation of the event?
|Do healthcare providers offer an empathetic acknowledgment to the patient/family as soon as possible after an unanticipated outcome?
|Does your healthcare organization hold predisclosure preparation meetings for providers and staff members who will participate in the disclosure process?
|Are disclosure meetings with patients/families scheduled as soon as practical following unanticipated outcomes?
|Does your healthcare organization notify its professional liability carrier about disclosure meetings?
|Does your healthcare organization determine in advance of a disclosure meeting who will participate on behalf of the organization and the patient?
|Is an appropriate individual assigned to lead the disclosure meeting?
|Is the disclosure meeting held in a private and secure area?
|Is your healthcare organization’s risk management staff involved in the initial disclosure conversation and subsequent patient follow-up?
|Do all healthcare employees involved agree on an agenda and the information that will be discussed before the disclosure meeting?
|Does the disclosure meeting involve explaining the plan of action relative to either continued investigation or process changes that might help prevent similar outcomes?
|During the disclosure meeting, are the patient/family given an opportunity to ask questions and clarify information?
|Are the patients/family provided with an organizational contact who will provide follow-up information as it becomes available?
|Are additional counseling services offered to the patient/family, and are they given the names of agencies that they can contact to address their concerns or complaints?
|Has the disclosure leader established a date and time for follow-up communication as more information becomes available based on developments from investigating the event, changes in the patient’s condition, or modifications to the treatment plan?
|Does the disclosure leader or another appropriate team member document who attended the disclosure meeting and the content of the disclosure in the patient’s health record?
|Does your organization conduct a debriefing session with the disclosure team to determine support needs and to review the disclosure process?
|Does your organization offer a second victim support program for healthcare providers and staff members who are involved in unanticipated outcomes?
|Has your organization developed written policies and procedures for second victim support and resources, and have organizational leaders, providers, and staff been educated about them?
|Does your organization’s second victim support program include rapid response provisions?
For more details on disclosure — including information about training for disclosure, the process of disclosure, disclosure documentation, and second victim support — see ChiroPreferred by MedPro’s guideline Disclosure of Unanticipated Outcomes and Risk Resources: Disclosure of Unanticipated Outcomes.
1 For the purposes of this publication, unanticipated outcomes refer to (a) outcomes of care that differ significantly from anticipated outcomes, (b) medical errors caused by deviations in the standard of care, and (c) patient harm that results from medical mismanagement or system failures.
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