Supporting Healing. Restoring Hope.

Transcription

1 Session Code: M22 This presenter has nothing to disclose Supporting Healing. Restoring Hope. Linda K. Kenney President, MITSS (Medically Induced Trauma Support Services) IHI Forum, December 2013 Orlando, FL Session Objectives To create awareness about the emotional impact that medical errors and adverse medical events have on patients/families and caregivers. To explore the presence or absence of support services that exists in respective institutions. To identify and discuss the barriers that prevents the utilization of these supports. To introduce Emotional Support Activation (ESA) for patients and families and to introduce the Peer Support Team models for emotional support for caregivers and discuss the critical components for successful implementation. 1

2 We all have stories Background November 18, 1999 Immediately following Discharge Husband, children, family and friends Physically Letter from Dr. van Pelt What Patients and Families Want Following Adverse Medical Events Transparent communication in real time An Apology or an acknowledgement Organizational response to prevent recurrence Support (unique for each individual) 2

3 Another Patient s Story 5 Working Definition Medically Induced Trauma is an unexpected outcome that occurs during medical and/or surgical care that affects the emotional well being of the patient, family member, or clinician(s). Adverse Event Medical Error Unanticipated Outcome Known complications Harm due to medical intervention 3

4 Trauma Trauma is a part of the human experience. The trauma response occurs when a person experiences or witnesses a sudden, terrible, and unexpected event, which temporarily destroys his/her ability to cope as normal. Trauma is essentially a normal response to an abnormal or extreme event. Where is the Support \ax -+*9637*4 Ew211q1` Organizations f v cfbm,yt5rt5we3ui hjujm, e Research Education Counseling Influence Local with Internet Reach Pulse America.org x x x x Consumers Advancing Patient Safety x x x American Trauma Society x x x x x National Patient Safety Foundation x x x x x American Iatrogenic Association x x x x JCAHO x x Institute for Safe Medication Practices x x x x National Forum for Health Care Quality Measurement & Reporting x x x Center for Medical Consumers x x x x The Leapfrog Group x x x x Institute for Healthcare Improvement x x x x Institute of Medicine x x x Minnesota Alliance for Patient Safety x x x x Web-based only National Presence 4

5 Medically Induced Trauma is Unique Patients and Families may feel: Isolated, because hospitals often are not set up to provide emotional support beyond the hospital stay. Breach of Trust between caregiver and patient that is so crucial to recovery. Vulnerable, since, in most cases, the patient will need continued care within the same system that harmed them. Additional Trauma Responses After Adverse Medical Events Patients and families may feel a mix of emotions following an adverse medical event, including: Sadness Anger Mistrust Isolation A desire to connect with others Guilt Shame Fear Loss Grateful to survive Ambivalent 5

6 Responses While Impatient Patients Denial/Shock Focused on physical recovery Focused on Family Worried Ambivalent Grateful/Angry Families Angry Guilty Protective Worried about health of loved one Shock L E N D Support to a patient or family member impacted by an adverse medical event 6

7 LISTENING EMPATHIC RESPONSE NEEDS ASSESSMENT DIRECT TO SERVICES Road Kill 7

8 Peg Metzger Description Brief History of Clinician Support In 1985, physician wrote an article in the NEJM about his error and how he felt about it. The 1990 s a few studies on pressure and errors on docs. In 2000, Dr. Wu coined the term Second Victim In 2004, Dr. van Pelt and I spoke at the NPSF Congress When Things Go Wrong Document ( MITSSStory: u0&feature=channel_video_title Disclosure and Apology, What s Missing? Programs that Support clinicians ( Susan Scott s work on Second Victims CRICO/RMF s Newly released film Healing the Healers ( 8

9 Today Joint Commission Hospital Leadership Chapter 7/1/2012 The Leaders make support systems available for staff who have been involved in an adverse or sentinel event NQF Safe Practices Practice 7: Disclosure Practice 8: Care of the Caregivers Clinician Support Tool Kit for Healthcare Released December Over 23,000 unique visitors Over 2,407 requests for downloadable copies Tools for Clinicians, Patients and Families and Healthcare Organizations 9

10 What Second Victims Want From Susan Scott, University of Missouri Barriers to Change The Clinician as Super Human Hippocratic Oath: First Do No Harm Feelings of shame, humiliation, and incompetence Lack of systems thinking Culture of fear around medical-legal action The emotional discomfort around events Lack of understand of the impact to ALL 10

11 What s Needed Organizational Response Plan Need Malpractice insurers to be part of the plan Training Disclosure Education around the emotional impact to everyone involved: patients, families, clinicians, admin staff, etc What s Needed (Cont d) Support for Clinicians For the disclosure conversation Following the event During the investigation Ongoing support If needed, during a law suit Collectively, we need to make it OK for clinicians to access and utilize various supports. Make sure we give patients/families information or resources to address the emotional impact they may experience. 11

12 Healing the Healer Thank you for your attention Contact Information Linda Kenney MITSS