CAReand PFAC: How patient input helped BIDMC s Communication, Apology, and Resolution program to succeed Health Care For All PFAC Conference May 14, 2014
BIDMC s PFAC Started in 2010 Composition: 17 patient/family advisors, 6 staff Invite staff to present and welcome staff to request the opportunity to present Strategic in-reach to staff working on quality and safety issues Goal: Align work of PFAC and work of hospital
What is Communication, Apology, and Resolution? A transparent and honest approach to adverse events. Components of CARe: Culture of Safety, including encouraging reporting Communication with patients when things go wrong Empathy and apology An apology of responsibility will be given if there was an error. Timely and fair injury compensation outside of the court system Attorney representation is encouraged Improvement of systems and practices through learning from adverse events, and reporting the improvements to harmed patients
What is MACRMI? MACRMI: The Massachusetts Alliance for Communication and Resolution following Medical Injury An alliance of patient advocacy groups, hospitals, their insurers, and statewide provider organizations committed to transparent communication, sincere apologies and fair compensation in cases of avoidable medical harm. BIDMC is a member of this organization. www.macrmi.info
MACRMI Membership
PFAC s Work for CARe, 2013-2014 Assist in developing our CARePatient Brochure help clarify CARe spurpose find an appropriate tone determine ways that it could be more helpful to patients Review our Patient Best Practices Document ensure that the Best Practices describe how patients would want to be treated after an adverse event create consistent clarity and tone in the document Assist in redesigning the required Massachusetts DPH SRE letter templates help us understand possible patient reactions to these required letters improve the letters to better serve their purpose
CARePatient Brochure Purpose of brochure: To help patients better understand what CAReis, and how it works. Audience: Patients in general, but mainly those who have experienced an adverse event. PFAC s Contributions: Greater emphasis on communication Clarify the decider in each step of the process Clarify how to initiate the process if you re a patient Clarify legal rights Elimination of the word money Addition of clearer bulleted formatting throughout
The CARe Patient Brochure Front Cover Inside Flap Back Cover
CAReBest Practices for Patient Interaction Purpose of the document: to make it clear that patients are an essential part of the CAReprocess, and to guide CAResites in how to best work with patients who have been harmed. Audience: Staff at CAResites (and potential sites) PFAC s Contributions: Simplify the language, and bold important points of practices so that staff can read quickly and easily. Add a separate practice that focused on Listening.
Revised Best Practices
State-Required DPH letters for SREs Massachusetts health care facilities are required to send letters to patients at 7 and 30 days after an event, if they experience what the state calls a Serious Reportable Event (adverse events that are seriously harmful to patients such as hospital acquired infections, wrong site surgeries, falls, etc.) Audience: Patients who have been harmed Purpose of the document: to ensure that patients are fully informed about adverse events they experienced
PFAC s Contribution to the DPH Letters Reframe each letter entirely! Human First we are telling you because we are committed to being transparent and to treating you like a human being, not because we re required to by law. Bigger concerns Discussion first Reopening the wound Transfer of personal information
New DPH 7 and 30 Day letters Rewrote both letter templates entirely, based on feedback Now in use at BIDMC, with future expansion to our affiliates Associate Commissioner of the DPH reviewed and really liked them, and appreciated our joint effort
PFAC Member Perspective Appreciate the concept of apology without blame. Able to give insight regarding how a patient might view the situation. Thrilled there is a forum for patients who feel something has been done that deserves attention but may not want a suit. Makes the institution more human and the patients feel more respected.
Questions? Contact information Melinda Van Niel, Project Manager, CARe/MACRMI mvanniel@bidmc.harvard.edu ElanaPremack Sandler, Project Leader, Patient and Family Engagement epremack@bidmc.harvard.edu Holly Thomas, PFAC Member zubsha@gmail.com