A Novel Challenging Role for Pathologists: Direct Verbal Communication of Autopsy Findings to Families in a Risk Management Program
Ada Quintana, Timothy McDonald, Andre Kajdacsy-Balla, Tibor Valyi-Nagy. University of Illinois Medical Center, Chicago, IL
Background: Research indicates that effective communication following unexpected harm is essential to maintaining patient and family trust. Within the federally funded patient safety program at the University of Illinois Medical Center at Chicago (UIMCC) pathologists have become uniquely involved in UIMCC's comprehensive communication process following patient harm events. The objective of this research was to identify key competencies required of pathologists to function successfully in such a multidisciplinary program.
Design: The safety and risk management team facilitates interdisciplinary communication with patients and families following all serious harm, including death. The team assesses the effectiveness of these communications and tracks claims data. Members of the interdisciplinary team reviewed data related to participation of autopsy pathologists in the program and identified quantitative and qualitative outcomes, as well as key desired competencies.
Results: From 2006-2008, risk management facilitated 127 patient/family communication consultations. A UIMCC pathologist participated in five and of these an autopsy was performed in four. When a pathologist was involved, their competency in the process was assessed favorably by risk management and rated positively by the family members. None of the cases that involved a pathologist resulted in a claim. The consensus of the interdisciplinary team was that in addition to medical knowledge, the most important competencies for pathologists to successfully participate in the process are compassion, empathy, and the ability to establish patient trust.
Conclusions: Following harm, effective communication processes allows the multidisciplinary team to learn and improve. The pathologist can play a pivotal role as part of a multidisciplinary team in providing objective data while answering questions to help families understand the cause[s] of death, thereby, eliminating the need to pursue litigation to get questions answered. Successful participation in these increasingly prevalent programs requires pathologist to use skills not traditionally central to pathology practice and pathology training programs. These experiences will lead to the increased recognition of the importance of autopsies by clinicians and underline the indispensible role of autopsies in risk management programs.
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 11, Wednesday Morning