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communication basics in critical situations. Systemizing disclosures through structured programming helps healthcare institutions bridge the gap between their clear reporting systems and the often vague requirements and steps regarding actual patient and family disclosures. By implementing these training programs, institutions can improve the consistency and effectiveness of communication during adverse events, ensuring that clear reporting systems align with the requirements and steps for disclosing information to patients and their families. One notable strength of the referenced training materials is their recognition of the significance of a provider “huddle” before conducting the disclosure. This collaborative approach allows the healthcare team to synthesize relevant information, establish a plan for communicating with the family, and identify the primary individuals who should lead the discussion. The training also emphasizes the value of role-playing and rehearsing the disclosure conversation, including anticipating potential questions from the patient and family. In addition, the SPS program includes a helpful template that can guide the exchange and facilitate documentation after the disclosure conversation. These materials can be customized to align with the organization’s specific disclosure policy and meet state regulatory requirements. Standardizing these templates and resources promotes effective communication by normalizing the process, which, in turn, reduces stress and anxieties for clinicians delivering the disclosure. Furthermore, it provides clear and structured guidance for clinicians to navigate critical and emotionally charged situations. In addition to the positive impacts on transparency, empathy, and managing expectations for patients and families, regular simulation exercises focusing on the pre- disclosure “huddle” and subsequent adverse event disclosures offer valuable professional and faculty development opportunities for students, trainees, and healthcare providers. These simulations serve as powerful learning tools within departments and health systems. Participants and observers of these simulations have ample opportunities to review and
discuss various aspects of the disclosure conversation. This includes analyzing the content of the discussion as well as paying attention to important details such as the avoidance of medical jargon, maintaining an appropriate tone, being mindful of body language and unspoken cues, and pacing the conversation to allow the recipient of the disclosure sufficient time to process information and ask questions. By experiencing controlled exposure to the components of these conversations and the heightened stress and anxiety associated with them, trainees and faculty members can develop the skills necessary to remain organized and composed when delivering disclosures to actual patients and their families.
Children’s Hospitals’ Solutions for Patient Safety. (n.d.). Disclosure Training Manual. Retrieved June 7, 2023 from https://static1.squarespace. com/static/62e034b9d0f5 c64ade74e385/t/63cedcd9ad39 e157434a451f/1674501338405/ Disclosure%2BTraining%2BProgram% 2BManual.pdf 2 (OCR), Office for Civil Rights (2020). 2069-Under HIPAA, when can a family member of an individual access the individual’s PHI from a health care provider or health plan? Retrieved June 7, 2023 from https://www.hhs. gov/hipaa/for- professionals/faq/2069/under-hipaa- when-can-a-family-member/index. html 3 Peterson, K. A., Rutherford, M., Drvol, D., Barkman, D., Phipps, A. R., Hales, R., Dawson, A., Stevens, L., Teman, S., & Teets, J. (2019). Disclosure of Adverse Events: A Guide for Clinicians. Pediatric Quality and Safety, 4(4), e185. doi:10.1097/pq9.0000000000000185. 4 Powell, S. K. (2006). When things go wrong: responding to adverse events: a consensus statement of the Harvard hospitals. Lippincott’s Case Management, 11(4), 193-194. doi: 10.1097/00129234-200607000-00001.
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