Pre-Workshop Module: Preparation for Disclosure and Apology

Pre-Workshop Module: Preparation for Disclosure and Apology

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Accredited Course

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Courses that have the CE logo on the image have a designated number of certified continuing education credits associated with the course. These courses have a fee, and upon completion, the learner will receive a certificate with their designated credits which can be used for re-licensure. The continuing education credits available are physician credits and nursing credits. This also includes risk management credits.

Non-accredited Course

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Courses are free, self-paced, and open-enrollment that may be started and completed at any time. You will receive a certificate of Completion once you finish the course.


Accreditation/Designation Statements

In support of improving patient care, Boston Children's Hospital is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for the healthcare team.

Physician

Boston Children's Hospital designates this live activity for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only credit commensurate with the extent of their participation in this activity.

Risk Management

Advancing Relational Learning Worldwide: Disclosure and Apology Part I meets the requirements of 2 Risk Management Credit as prescribed by the Massachusetts Board of Registrations in Medicine and defined in 243 CMR 2.06(5)(d) I. 

Nurse

Boston Children's Hospital designates this activity for 2 contact hours for nurses. Nurses should only claim credit commensurate with the extent of their participation in the activity.

Course Information

Preparation for Disclosure and Apology is part of a 3-module based course, Disclosure and Apology After Medical Error and Adverse Events, that can be taken either as a stand-alone module or as part of the full course. Full course details can be found on the course group page.

In this module, you will be introduced to the rationale for disclosure and apology and exposed to profound experiences of error and disclosure and apology from the perspectives of patients and providers. You will have opportunities to reflect on your learning throughout the module and get access to state-of-the-art-tools, tips, and guidelines that you can use to support successful disclosure and apology conversations.

Course Format

Self-paced, using text and video, with post-test assessments. The course will cover:

  • Why Disclosure and Apology is Needed
  • Patient and Family Experiences and Perspectives
  • Clinician Experiences and Perspectives
  • The Power of Conversation
  • Preparing for Disclosure and Apology
  • Best Practice Guidelines and Tips
  • The Need for Practice

About Disclosure and Apology after Medical Errors and Adverse Events

Disclosure and apology conversations after medical errors and adverse events are vital to safer, high-quality healthcare. However, speaking with patients or their families after a medical error or an adverse event is one of the most difficult conversations a clinician can have. Most clinicians have little or no training in how to prepare for and conduct these conversations. This Disclosure and Apology course equips you with the tools, skills, confidence, and practice needed to conduct these difficult conversations and to help you seek appropriate support when you need it.

Visit the course group page.

Instructional Time

2 hour, 00 minutes

Target Audience

  • Physicians
  • Trainees
  • Nurses

Expiration Dates

  • Released: November 8th, 2016
  • Reviewed: November 8th, 2017
  • Expires: November 8th, 2018

Privacy Policy

Access the Boston Children's Hospital CME Privacy Policy here.

Learning Objectives

By taking all three modules of the Disclosure and Apology After Medical Error and Adverse Events course, you will be able to:

  • Describe why disclosure and apology is the right thing to do
  • Identify professional barriers to disclosure and apology
  • Recognize the emotional impacts of medical errors and adverse events on patients, families and clinicians
  • Identify the challenges and benefits of disclosure and apology conversations for patients, families and clinicians
  • Describe the TRACK core relational values for disclosure and apology
  • Apply suggested guidelines and tips for preparing for holding and debriefing/follow up after disclosure and apology conversations
  • Describe the role and importance of disclosure coaches and use/recommend their use
  • Identify key personal and institutional steps necessary for meaningful disclosure and apology conversations
  • Recognize that the patients and families may still be angry, even if conversations go well
  • Assess approaches to disclosure and apology across the range of error cases in pediatrics
  • Evaluate whether how and what to disclose for each case
  • Recognize the importance of support and fair resolution for both clinicians and patients
  • Examine the range of support available to clinicians across settings
  • Assess support in own setting
  • Examine the role of peer support and determine its essential features
  • Describe the features of a “just culture” for clinicians
  • Identify the sequence of errors that occurred in the example case
  • Critique the opportunities and challenges posed by technology for medical error and effective communication
  • Compare attitudes and practices on disclosure and apology in the example setting with those in own country/setting

 Visit the full course group page for more information.

Contributors

Stephen Brown, MD

Staff Physician in Radiology, Boston Children’s Hospital, Associate Professor of Radiology, Harvard Medical School, and Director, Institute for Professionalism and Ethical Practice

Robert Truog, MD

Frances Glessner Lee Professor of Medical Ethics, Anaesthesia, and Pediatrics, and Director, Center for Bioethics, Harvard Medical School; Executive Director, Institute for Professionalism and Ethical Practice, and Senior Associate in Critical Care Medicine, Boston Children’s Hospital

Beth Daley Ullem, MD

National Patient Safety Advocate, Board Director

Jo Shapiro, MD, FACS

Chief, Division of Otolaryngology in the Department of Surgery, Brigham and Women’s Hospital

Dr. Paul Hickey, MD

Anesthesiologist in Chief, Department of Anesthesiology, Perioperative and Pain Medicine Research, Boston Children’s Hospital

Mr. David Browning, MSW, BCD, FT

Co-Founder, Institute for Professionalism and Ethical Practice, Boston Children’s Hospital

Ms. Brenda Allair, M.Ed

Parent, Special Education Coordinator

Ms. Linda Kenney

Founder and Director, Medically Induced Trauma Support Services (MITSS)

Dr. Frederick van Pelt, MD

Associate Clinical Principal, The Chartis Group

Dr. Patricia Folcarelli, PhD, RN

Director of Patient Safety, Beth Israel Deaconess Medical Center

Mr. Mark Blazey, MS, CRNA

CRNA at Boston Children’s Hospital

Dr. Kenneth Sands, MD, MPH

Senior Vice President of Health Care Quality and Chief Quality Officer, Beth Israel Deaconess Medical Center

Dr. Robert Wachter, MD

Professor and Chief of the Division of Hospital Medicine, University of California, San Francisco School of Medicine

Dr. Andrew Carson-Stevens, MD

Clinical Lecturer in Health Care Improvement, Institute of Primary Care and Public Health, Cardiff University

Dr. Marisa Brett, MD

Associate Physician in Medicine, Assistant Professor in Pediatrics, Harvard Medical School

Dr. Eric Fleegler, MD, MPH

Associate Physician in Medicine, Assistant Professor of Pediatrics, Harvard Medical School

Ms. Christine Rachwal, RN, MSN, CCRN

Clinical Nurse Specialist, CICU, Boston Children’s Hospital

Disclosures

In accordance with the disclosure policy of Boston Children's Hospital and the standards set forth by the Accreditation Council for Continuing Medical Education, course planners, speakers and content reviewers list below any relevant relationships they or their spouse/partner have to companies producing, marketing, re-selling or distributing health care goods or services consumed by or used on patients.

Instructor Disclosures

No disclosures to report:

Dr. Robert Wachter, Dr. Kenneth Sands, Dr. Andrew Carson-Stevens, Dr. Frederick van Pelt, Dr. Patricia Folcarelli, Dr. Jo Shapiro, Mr. David Browning, Mr. Mark Blazey, Dr. Robert Truog, Dr. Elaine Meyer, Dr. Paul Hickey, Ms. Beth Daley Ullem, Ms. Brenda Allair, Ms. Linda Kenney, Dr. Marisa Brett, Dr. Eric Fleegler, Ms. Christine Rachwal, Dr. Stephen Brown

Content Reviewers

No disclosures to report:

Dr. Donna Luff, Ms. Lesley Niccolini, Dr. Robert Graham, Ms. Erin Ward

Commercial and Financial Support Disclosure

This program receives no commercial support.