Unanticipated outcomes cont… • The requirement to disclose unanticipated outcomes is an affirmative obligation, which, like prospective disclosure of risks, emanates from patient autonomy and the patient’s right to know. • Covering up errors is not permitted.
What disclosure should include • Timely disclosure should include: • What happened • The causes, if known • Any known effects on the patient's short term and long term health • Only clinical information regarding the occurrence is to be documented in the patient’s medical record.
The disclosure process • An attending or their designee should inform patient and/or families of the unanticipated outcome(s) as soon as reasonably possible, either: • Within 2-3 hours of the occurrence or the recognition of such; • Within the same shift or the occurrence or its recognition. • As reasonably possible, the same individual should communicate with the patient/family.
The disclosure process cont… • If possible a single individual, either the patient or family member, should be identified as primary contact for (daily) communication. • The disclosure and ensuing conversations should take place in a location that assures patient privacy and confidentiality.
The disclosure process cont… • Given that the issue of disclosing unanticipated outcomes requires a coordinated institutional response, the provider should contact risk management prior to patient/family disclosure.
Related Policy • For policy related to Sentinel Events, see “Sentinel Events” policy on Gradynet.