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Thu, 09/23/2010 - 12:34pm
The Value Of An Apology The value of a heart-felt "I'm sorry" – can be seen in many facets of our lives. Often, no matter how big or small the mistake, an apology is a good start to remedying the situation. Still, it seems to be human instinct to try to cover up the mistake, not talk about it or deny that it happened.

As a student, did you ever make a tiny, miniscule mistake that no one noticed? Did you point it out to your superiors, even if it had no impact on the patient or procedure, or did you let it slide, learn from it silently, and move on? In hospitals, when a clinician makes a mistake that impacts a procedure, it's often the risk management strategy to not discuss the event amongst colleagues or with the family for fear of litigation. But is this the best way to approach medical errors? According to a recent article on nytimes.com, the value of an apology is strong when it comes to medical errors. As Dr. Pauline W. Chen writes, "open disclosure with patients about medical errors has been positively linked with patient satisfaction for years." A study published in The Annals of Internal Medicine supports the idea that apologizing for medical errors decreases liability costs and does not lead to more malpractice suits. Supporting reports on this study state that in 2001 the University of Michigan instituted a policy prompting staff to report medical errors, apologize for them and offer compensation when a medical error caused injury. Before this policy, the health system would forward claims to a defense counsel to review and advise on whether to settle or go to trial. The study found that new claims, liability costs and the time it took to resolve claims all went down after the policy was implemented. Additional findings about the impact of such a policy include: The time it took to resolve a claim decreased from approximately 16 months to less than a year. The monthly rate of new claims fell from about 7 per 100,000 patient encounters to about 4.5 per 100,000. The number of lawsuits decreased from 38.7 per year to about 17. Annual spending on legal defense decreased 61 percent, and the average cost per lawsuit decreased from $405,921 to $228,308. The study predicts multiple explanations for these results – perhaps that the policy generated a safer culture, or that patients were more satisfied with being offered an apology and explanation for an error rather than simply being shut out, so they decided not to sue. Either way, it seems this policy has contributed multiple benefits for the hospital. Surgeons and surgical staff are humans, and being such, mistakes will be made. This study suggests that patients and their families actually do understand the humanness of their doctors, and they are more willing to hear from a clinician who has made a mistake if they are treated with the respect and dignity they deserve That, it seems, often starts with an apology.
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