Sorry Works! up Book

By Doug Wojcieszak

Want to elevate your disclosure efforts UP from good to great? Achieve greatness with your disclosure program by learning from your colleagues around the country. This user friendly text is loaded with stories and questions about disclosure from healthcare, insurance, and legal professionals working to master disclosure. This is the essential reference tool for anyone developing and operating a disclosure program, including risk and claims managers, defense attorneys, CEOs, CMOs, nursing managers, physicians and nurses, clinical ethicists, and patient advocates.

• Language: English
• Publisher: AuthorHouse
• Release date: Oct 22, 2012
• ISBN: 9781477277256

Doug Wojcieszak

Doug Wojcieszak is a disclosure training consultant with several personal and professional experiences with tort reform and medical malpractice issues. A nationally recognized leader in the disclosure movement, Wojcieszak founded Sorry Works! and has trained thousands of healthcare, insurance, and legal professionals across the United States and around the world. Wojcieszak co-authored the best-selling Sorry Works! Book, authored the Little Book of Empathy, and partnered with ELM Exchange to provide on-line disclosure training modules for front-line staff in acute and long-term care settings.

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© 2012 Doug Wojcieszak. All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

Published by AuthorHouse 10/17/2012

ISBN: 978-1-4772-7726-3 (SC)

ISBN: 978-1-4772-7725-6 (e)

Library of Congress Control Number: 2012918748

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Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

Table of Contents

A QUICK REFRESHER ON DISCLOSURE: SORRY WORKS! 101

IT’S NEVER TOO LATE TO SAY I’M SORRY

PLAN FOR FIRE OR TORNADO? WHAT ABOUT DISCLOSURE?

MAKING EMPATHY A REFLEX FOR FRONT-LINE STAFF

EMPATHY IS FOR EVERYONE, ALL THE TIME… SORRY AFTER LITTLE, EVERYDAY EVENTS

SHARING BAD NEWS OVER THE PHONE…EMPATHY ON SPEED DIAL

ON-LINE EMPATHY: SORRY FOR BAD REVIEW

SHUTTING DOWN INSTITUTIONAL COMMUNICATIONS POST-EVENT

UNDER PAYING ON A CASE? OVER PAYING ON A CASE? GETTING COMPENSATION RIGHT

BRIDGING THE GAP BETWEEN RISK/CLINICAL FOLKS & CLAIMS FOLKS

DISCLOSING ERRORS VOIDS INSURANCE COVERAGE? HELPING INDEPENDENT PHYSICIANS THINK THROUGH DISCLOSURE

REVIEW, NOT INVESTIGATE

AVOIDING MUSH STATEMENTS POST-EVENT

REMEMBER TO INTERVIEW PATIENTS & FAMILIES POST-EVENT

SETTING REASONABLE EXPECTATIONS POST-EVENT

BALTIMORE AREA-HOSPITALS REFERRING PATIENTS AND FAMILIES TO PERSONAL INJURY LAWYERS…..REALLY?

RESPONDING TO TRIAL LAWYER ADS WITH LOVE AND SORRY

NEW HOSPITAL MARKETING STRATEGY: WE MAKE MISTAKES?

MEDICAL ERRORS, THE MEDIA, AND REGULATORS….MAKING PEACE WITH THE GOTCHA CROWD

BEHIND-THE-SCENES DOCS & DISCLOSURE….STEP OUT FROM BEHIND THE SHADOWS!

DON’T FORGET 2ND VICTIMS OF MEDICAL ERRORS

PREMATURE APOLOGIES HURT FAMILIES, TOO

CRITIQUE OF A HOSPITAL’S DISCLOSURE POLICY

ADDITIONAL CRITIQUE OF DISCLOSURE POLICIES – CONFUSION OVER ADMITTING FAULT

VALIDATE COMPLAINT BEFORE RESPONDING

WHEN EMPATHIZING, TAKE A WITNESS…

TALK ABOUT THE PATIENT YOU KILLED YEARS AGO - AN ACE IN THE HOLE FOR DISCLOSURE

CAREGIVERS WHO SUFFER ADVERSE EVENTS: ANOTHER ACE IN THE HOLE FOR DISCLOSURE

REMEMBER PATIENT-FAMILY PERSPECTIVE DURING DISCLOSURE

COMMENT FROM ROAD: DISCLOSURE NOT DOCUMENTED!

QUESTION FROM ROAD: ANYONE TAPING THIS CONVERSATION?

QUESTION FROM ROAD: DEFENSE LAWYERS NOT ON BOARD? FIRE THEM!

QUESTION FROM ROAD: EMPATHY MISUNDERSTOOD AS APOLOGY/ADMISSION OF FAULT?

QUESTION FROM ROAD: NURSE SAYS ERROR?

QUESTION FROM ROAD: GONNA FIRE THE NURSE?!?

QUESTION FROM ROAD: PRIOR DOC MESSED UP?

QUESTION FROM ROAD: CONFIDENTIAL SETTLEMENT, OR NOT?

QUESTION FROM ROAD: CAN SETTLEMENTS INVOLVE MORE THAN MONEY?

QUESTION FROM ROAD: WE STILL GOT SUED, SO ‘SORRY’ DIDN’T WORK?!?

QUESTION FROM ROAD: WHERE’S THE CHART?!!

QUESTION FROM ROAD: FAMILY DOESN’T BELIEVE YOU WILL REVIEW CASE?

QUESTIONS FROM ROAD: SYMPATHY CARD? FUNERAL?

QUESTION FROM THE ROAD: WHO’S PAYING?!?

QUESTION FROM ROAD: AGREE TO DISAGREE AT END OF DISCLOSURE PROCESS?

MAKING DISCLOSURE TOP OF THE MIND – AND KEEPING IT THERE

Dedicated to my wife Jeanne, who, by always watching our beautiful kids (Will and Claire) while I’m on the road, has given me the ability to travel the country educating doctors and nurses about disclosure.

Love you!

Introduction….Important to Read this First!

Welcome to the Sorry Works! UP Book…..the book where we elevate your disclosure program UP to the next level. Where we take good disclosure programs and make them truly great….great for not only patients and families but also doctors and nurses, risk and claims managers, defense attorneys, and hospital and insurance executives. Everyone wins with UP!

Disclosure has so much promise…the ability to not only lower litigation and associated expenses but also dramatically improve patient safety while simultaneously increasing job satisfaction for caregivers. Moreover, with disclosure we can provide real healing and closure for patients, families, and caregivers. However, to truly attain and enjoy these benefits you have to take your disclosure program UP to the next level….a good disclosure program is not good enough! Your program has to be GREAT. And this is why I’m so excited to bring this book to you because it will help so many people.

Many organizations are doing disclosure, but it’s on ad hoc basis or their program is not yet very strong. Ethically consistent behavior post-event is still elusive. This book was written for folks/organizations in this situation, to help them have stronger, more consistent disclosure programs.

UP was literally built from hundreds of speeches all around the country and also countless phone calls and e-mails with healthcare, insurance, and legal professionals. These are truly questions from the road, and tales from the trenches. Each section of the book was literally born from conversations and interactions with people just like you who are trying to master disclosure. Indeed, this text gives you the chance to learn from your colleagues around the country.

The real value of Sorry Works! in the disclosure movement is that each day we talk and interact with people all around the country, in all sorts of different situations, and then we share these interactions and learning experiences with everyone. UP captures all of these learning experiences – the true power of Sorry Works! – in one book you are now holding.

EACH SECTION OF THE

BOOK WAS LITERALLY

BORN FROM

CONVERSATIONS AND

INTERACTIONS WITH

PEOPLE JUST LIKE YOU

WHO ARE TRYING TO

MASTER DISCLOSURE.

THIS TEXT GIVES YOU

THE CHANCE TO LEARN

FROM YOUR COLLEAGUES

AROUND THE COUNTRY.

When you look at the Table of Contents on the next page you will notice a series of topics and page numbers, but no chapter numbers. Obviously, each topic revolves around disclosure, but each topic is truly distinct from all others in the book. You can read the book in whatever order you wish….choose what topic is most important to you and begin there.

Finally, thank you for purchasing the UP book. I truly appreciate it when people and organizations spend money – especially in this economy – on Sorry Works! products and services. We have enjoyed tremendous support over the years and are very grateful. I hope this book meets all of your expectations.

If you have any questions or comments, or would like to learn more about how Sorry Works! can help your disclosure program, please feel free to call anytime at 618-559-8168 or e-mail [e-mail].

Sincerely,

      Doug

Doug Wojcieszak, Founder

Sorry Works!

PO Box 531

Glen Carbon, IL 62034

618-559-8168 (direct dial)

[e-mail] (direct e-mail)

A QUICK REFRESHER ON

DISCLOSURE: SORRY WORKS! 101

Before we take your disclosure program UP to the next level, let’s do a quick refresher on disclosure. Let’s make sure we are all on the same page.

At Sorry Works!, we believe the majority of patients and families whom file medical malpractice lawsuits do so out of anger, not greed. These people become angry when caregivers and healthcare organizations abandon them post-event, do a very, very poor job communicating, and/or are not empowered to help fix post-event problems. If pro-active, problem-fixing behavior is absent post-event, litigation will often follow.

We believe the key to true medical malpractice reform is to teach clinicians how to be better communicators post-event and give them the tools and support to be pro-active with patients and families after something goes wrong. A crippling injury or death caused by error does not need to result in litigation so as long doctors and nurses stay connected with patients and families post-event, and have the ability – through their hospital or insurer – to fix problems, including financial problems.

We believe that even lawsuits filed out of greed, unreasonable anger, or an honest difference of opinion are helped by disclosure because all the gotcha factors (doctors running away, etc) are eliminated and not present in the evidence.

We believe empathy is always appropriate post-event. Absence of empathy – sorry – is the chief driver of many medical malpractice lawsuits. Litigants often say during depositions, No one said they were sorry. Clinicians need to be taught post-event how to empathize without prematurely admitting fault.

Empathy = I’m sorry this happened…..I feel so bad for you.

Apology/Admission of Fault = I’m sorry for this mistake….this is our fault.

We believe you should only apologize after a thorough review has proven a mistake or error. Even if we think a mistake happened or a colleague (or the team!) screwed up, we are not going to speculate or joust in front of the family….because hunches made in the heat of the moment often turn out to be wrong. Give the review time to truly determine if a mistake occurred, or not.

We believe that the success of a disclosure program rises or falls on the credibility of the review process. The review process must be credible. If an adverse event appears not to be caused by error, the event should be reviewed by reputable, outside experts – the kind any good PI lawyer would hire. You don’t want to look like you are grading your own papers! Indeed, the review needs to pass the smell test of the most aggressive personal injury lawyer. If the review shows an error with causation occurred, a meeting will be scheduled with the patient, family, and their attorney to begin the process of formally apologizing, including discussions of financial and non-financial support. If, however, the review shows no error occurred, a meeting is still scheduled which includes more empathy along with a full discussion of the review in order to avoid the filing of a non-meritorious lawsuit.

We believe that disclosure, by mitigating anger, has the ability to lower the number of medical malpractice lawsuits and the dollar value of settlements without ripping off patients and families – and the data shows we are right! Sorry does work! Moreover, we believe disclosure provides critical closure and healing for all sides, especially clinicians. Finally, we believe disclosure is the best patient safety initiative hands down, because when doctors and nurses are not afraid to talk about their mistakes, they have a better chance of improving systems and processes.

All the beliefs spelled out above constitute what we at Sorry Works! call disclosure. And disclosure works best (as far as litigation reduction, closure, and patient safety) when it is operated in a formal program, where hospital/insurer leadership embraces and owns the program and provides adequate training and support for front-line staff. You must have a PROGRAM to truly be successful at disclosure! The UP Book is about taking good disclosure programs and making them GREAT with questions from the road, and tales from the trenches.

IT’S NEVER TOO LATE TO

SAY I’M SORRY

The original Sorry Works! Book begins by retelling the May 1998 death of my oldest brother, Jim, due to medical errors in a Cincinnati, Ohio hospital and how the event was handled poorly by staff and leadership, resulting in litigation. It’s a powerful story that crystallizes what is wrong with deny and defend risk management practices.

I also start every Sorry Works! presentation and training seminar with Jim’s story, telling my audiences that the narrative provides many teachable