|
|
|
September 15, 2008 NEWSLETTER
Doug Wojcieszak, Founder & Spokesperson
Contact phone/e-mail address: 618-559-8168; doug@sorryworks.net
THIS WEEK'S EDITION:
- Sorry Works! E-Newsletters a Monday Afternoon Affair!
- Upcoming Sorry Works! Presentations
- Press Ganey and Stevens & Lee article with New Research on Reducing Liability Risk with Improved Patient Satisfaction
- "Learning How to Say 'I'm Sorry.'"
SORRY WORKS! NEWSLETTER NOW A MONDAY AFTERNOON AFFAIR
Summer and vacation season are over and kids are back to school - and it's time to get serious again about the challenges facing your hospital, medical practice, and/or insurance company. Sorry Works! is here to help by starting every week off right with the Sorry Works! e- newsletter. From this point forward look for the Sorry Works! e- newsletters on Monday afternoons. Also, throughout the work week continue to look for special Sorry Works! e-blasts on unique/special topics and disclosure products. Thanks for reading and supporting Sorry Works!
UPCOMING SORRY WORKS! PRESENTATIONS
Fall is in the air, and so is Doug Wojcieszak, Sorry Works! Founder - flying that is, to cities around the United States to make Sorry Works! presentations. Last Monday it was Indianapolis and Saturday it was the Philadelphia-area with Sorry Works! Co-Author Jim Saxton. This week it's New Jersey and St. Louis, next week Oklahoma, and the list goes on! Also Sorry Works! co-author Jim Saxton will be speaking at the Execusummit Conference near New York City and Boston. Busy months ahead.
To book a Sorry Works! presentation for your hospital, medical practice, insurer, or association, call 618-559-8168 or e-mail doug@sorryworks.net today!
PRESS GANEY AND STEVENS & LEE ARTICLE WITH NEW RESEARCH ON REDUCING LIABILITY RISK WITH IMPROVED PATIENT SATSIFACTION
At Sorry Works! we seek to provide outstanding content to you, our readers, through this newsletter and other services. Today is no exception. Below is an excerpt from a recent Press Ganey and Stevens & Lee article penned by Sorry Works! Book co-authors Jim Saxton, JD (jws@stevenslee.com), and Maggie Finkelstein, JD, along with Stefoni Bavin, MA, JD and Sarah Stawiski, PhD of Press Ganey.
The excerpt below discusses the all-important "plus factor" which is created when providers face difficult situations. Great article on reducing risk by increasing patient satisfaction. To view and read the entire article, paste the article's title - Reducing Liability Risk by Improving Your Patient Satisfaction - into Google and you'll find a PDF to view. We're sorry our software won't provide a direct link, however, Google works just fine and the article is definitely worth a few extra key strokes on your part.
The "Plus" Factor
One of the earliest studies on the relationship between patient satisfaction and provider liability was conducted by Gerald Hickson, MD, et al, and showed that poor communication was a factor to mothers of infants who had experienced permanent injuries or deaths and had closed malpractice claims. It is important to note that the study found that families overwhelmingly expressed dissatisfaction with physician-patient communication. Since Hickson's early work on the relationship between the patient's interactions with physicians and malpractice, there have been numerous studies that have reported similar findings. For example, Beckman et. al. examined plaintiff depositions to determine motivations for why patients filed suit against physicians and found that the relationship between the physician and patient comprised the majority of the motivation. Wendy Levinson, MD, et al, showed that better physician communication and behavior, for example, returning patient phone calls and being respectful to patients, was linked to fewer professional liability claims. The authors concluded that unsolicited patient complaints were positively associated with physicians' risk management outcomes. Later research by Hickson et. al. also found that patients seen by physicians identified as having the highest number of lawsuits were more likely to complain about communication issues with those physicians.
Most recently, Rodriguez et. al. found that the quality of the patient-physician interaction was negatively correlated with complaints. Positive interaction was defined as the physician provides clear explanations, gives understandable instructions, is caring, is kind, is aware of the patient's medical history, and spends enough time with the patient. In fact, the researchers found one standard deviation point increase in the quality of the interaction was associated with approximately a 35 percent lower chance of a patient complaint for primary care physicians and 50 percent for high-risk specialists.
Clearly there is a link between perceived quality of communication and interaction with provider and risk for malpractice claims. An effective way to measure patients' perception of the quality of communication during their interaction with their provider is through a patient satisfaction survey. Stelfox et. al. linked Press Ganey patient satisfaction survey results to patient complaints, risk management episodes, and malpractice suits. The authors found a significant relationship between physician ratings and patient complaints, with a 6 percent increase in complaints associated with a 1-point decrease in physician satisfaction ratings. Further, there was a 5 percent increase in risk management issues associated with a 1-point decrease in physician satisfaction scores. The results showed that compared with physicians with top satisfaction survey ratings, physicians in the middle tertile had malpractice lawsuit rates that were 26 percent higher and those in the bottom tertile had rates that were 110 percent higher.
There is further evidence from Press Ganey client experiences that an increase inpatient satisfaction scores is correlated with a decrease in claims and written complaints. For example, in an article based on data from St. John's Clinic, the authors examined records over a three-year period and found that patient dissatisfaction was significantly related to risk management experiences. A small number of physicians at the clinic were found to receive the majority of complaints, which makes tracking the number of complaints by physician a wise risk management procedure. Finally, this study found that patient dissatisfaction is an important identifier of malpractice risk, and that identifying and intervening with these physicians may aid in reducing risk as well as improving patient care.
"LEARNING HOW TO SAY 'I'M SORRY'"
Below is a great article on apology forwarded by Mr. Irwin Mortman, a great Sorry Works! friend from Cincinnati, Ohio. Thanks, Mr. Mortman.
Mr. Mortman is one of many Sorry Works! friends who regularly send us articles and ideas for the newsletter, which we greatly appreciate. If you have articles, ideas, or information to share, please pass them along to doug@sorryworks.net or fax to 618-692- 1352. Thank you!
Learning How To Say 'I'm Sorry.'
July 25, 2008
By Michael Craig Miller, M.D.
Harvard Medical School
Anyone who's had to apologize for something knows how difficult it can be to get the words out. Yet an apology is often the first step toward repairing a damaged relationship, be it personal or professional. Although not all mental health experts agree on this, an apology may be a prerequisite for forgiveness.
A Genuine Apology Fosters Healing
Conflict and error can occur in any relationship. People make mistakes, lash out in anger or say things they regret later. In fact, one of the main reasons people undergo psychotherapy is to try to resolve personal conflicts, betrayals and hurts. And some therapists integrate formal apologies into couples or family therapy.
To be effective, an apology has to be genuine, says Dr. Aaron Lazare, a professor of psychiatry and former chancellor of the University of Massachusetts Medical School, who has been studying this topic since 1993. Dr. Lazare has said, "A good apology can foster healing, but a faulty apology only makes a bad situation worse."
You need to understand the nature of the hurt you've caused and then address it in the apology. For example, if a person you have offended feels humiliated, then the apology might be worded in a way to restore self-respect and dignity. If you've made a mistake that causes someone an injury, damages property or causes some other financial loss, an apology might include a promise to provide compensation or take corrective action so the mistake doesn't happen again.
An apology doesn't guarantee forgiveness, of course. And in some cases the offended party may be too hurt or angry to accept an apology. One dramatic example is sexual abuse: Some victims may need to hear a genuine apology in order to come to terms with the injury, while others never want to deal with the perpetrator again.
Four Steps to a Genuine Apology
A genuine apology acknowledges an offense and expresses remorse. But it's hard for people to get it right. According to Dr. Lazare, an effective apology has four parts while ineffective apologies usually miss the mark in one of these areas.
1. Acknowledge the offense. The most common error people make is not to adequately acknowledge the offense by using vague or evasive language, or by wording the apology in a way that minimizes the offense or questions whether the victim was really hurt. Take responsibility for the offense, whether it was a physical or psychological harm, and confirm that the behavior was not acceptable. Sometimes people apologize for the wrong offense or address the wrong party.
2. Explain what happened. The challenge here is to explain how the offense occurred without excusing it. In fact, sometimes the best strategy is to say there is no excuse. "A humble remark is better than a dumb excuse," Dr. Lazare says.
3. Express remorse. If you regret the error, feel ashamed or humiliated, say so: This is all part of expressing sincere remorse.
4. Offer to make reparation. If the offense has hurt someone's feelings or caused a specific loss, acknowledge the pain, promise to be more sensitive in the future and offer appropriate compensation for any financial losses.
When apologizing, listen carefully to the offended person. This may be as important as speaking. Although it's never easy to remain quiet while someone else expresses anger, sadness or disappointment, it's necessary to truly hear what the person is saying. Active listening can help you understand what the other person wants from your apology, such as to restore dignity or to recognize fault.
Timing and delivery of an apology also matter. Although you should apologize as soon as possible after the mistake is discovered or acknowledged, a sincere apology may not be enough to restore trust after a significant personal betrayal. The person who feels wronged may need to know what specific steps will be taken to make amends and minimize future pain. This may take time and several conversations.
Examples of Good and Bad Apologies
Here are examples of effective apologies and why they work:
From one spouse to another: "I'm sorry I lost my temper last night. I've been under a lot of pressure at work, but that's no excuse for my behavior. I love you and will try harder not to take my frustrations out on you."
Why it works: The speaker is taking responsibility, explaining but not excusing the mistake, expressing remorse and caring, and promising reparation.
From a doctor to a patient: "I prescribed the wrong dose of your medication. I apologize for this mistake. It shouldn't have happened. I'd like to talk with you about what how we can safeguard your health in the future."
Why it works: The physician is taking responsibility, describing the mistake, expressing a caring attitude and beginning a conversation about how to remedy the error.
Here are examples of ineffective apologies and why they are a problem:
"I apologize for whatever happened."
Why it doesn't work: The language is vague and the offense isn't specified.
"Mistakes were made."
Why it doesn't work: Using the passive voice avoids taking responsibility.
"To the degree that you were hurt..."
Why it doesn't work: The wording casts doubt on whether the injured party was really harmed.
"Even the best people make mistakes."
Why it doesn't work: This expresses arrogance rather than humility.
If you are interested in making a genuine apology, try to validate that an offense has occurred and that you are at fault. In some instances, you may need to help restore a person's dignity and power. Make sure you show that you feel bad and that you care about the person you have hurt. This approach can provide an entre into a dialogue based on shared values, and you can begin to right a wrong.
Michael Craig Miller, M.D. is Editor in Chief of the Harvard Mental Health Letter. He is also associate physician at Beth Israel Deaconess Medical Center and assistant professor at Harvard Medical School. He has been practicing psychiatry for more than 25 years and teaches in the Harvard Longwood Psychiatry Residency Program.
|
|
|
|
