1 / 23

Restorative Circles in Hospitals: Reaching Closure When Things Go Wrong for Patients Melinda Zipin, MBA IIRP Conference,

Restorative Circles in Hospitals: Reaching Closure When Things Go Wrong for Patients Melinda Zipin, MBA IIRP Conference, Toronto, Oct 22-24 2008.

fabian
Download Presentation

Restorative Circles in Hospitals: Reaching Closure When Things Go Wrong for Patients Melinda Zipin, MBA IIRP Conference,

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Restorative Circles in Hospitals:Reaching Closure When Things Go Wrong for PatientsMelinda Zipin, MBAIIRP Conference, Toronto, Oct 22-24 2008 Copyright 2008 Melinda Zipin; to be used only in total.Melinda@assertivediplomacy.comSources: Hospital information: NYTimes online, May 18, 2008NVC based Restorative Circles: developed by Dominic Barter; email at: contact@restorativecircles.org

  2. When things go wrong (in the US) • Baby James Mannix • 11 days old • Several clinical errors based on review of medical record

  3. Unwanted clinical outcomes: What happens? Lawyers, insurers: “Deny and defend” Patients & families: No info, no accountability, no voice, no healing Clinicians: System breeds callousness Malpractice suit a life-changing event for all

  4. Pioneer US Hospitals • U Michigan • Johns Hopkins • Stanford • U Illinois • Some VA hospitals

  5. Disclose, apologize,compensate – Why? • Restore integrity • Avoid future errors: Learn • Reduce patients’ anger, foster healing • Accountability and healing for clinicians

  6. Were the lawyers right? • U Michigan - lawsuits and legal defense costs down by 2/3 • U Illinois - lawsuits down 50% 37 apologies -> 1 patient lawsuit

  7. Why do patients sue? • Anger at concealment and “blank wall” • Concern it will happen again

  8. What do patients want? • To understand what happened • To speak and be heard • From “victim” to empowerment • Accountability from clinicians

  9. Restorative Circles & NonViolent Communication (NVC) • Patients sue in an attempt to meet basic human needs: • Understanding • To speak and be heard • Empathy, caring, support • Empowerment, agency • Accountability • Mourning • Peace • Financial sustenance • Which needs are met through lawsuits?

  10. What is an NVC-based Restorative Circle? Facilitated meeting with dialogue Safe supportive environment in which to hold conflict Focus on hearing feelings and meeting needs Toward: Both healing and action plan

  11. Some Principles Each person gets to speak and be heard Restore, reconnect, and meet needs Voluntary; nonparticipation doesn’t stop circle “No doctors, no lawyers, no patients – just people”

  12. Who participates? Patient and family Physicians, nurses Others affected, others needed to resolve the conflict

  13. Pre-Circle What happened? Meaning for you? “Here’s the process” Consent

  14. In a Restorative Circle • “Where are you now?” • What did you hear? • Is that it? • “When you did that thing, what were you wanting?” • What did you hear? • Is that it? • “What next?” • What would you like to offer? • What would you like to request?

  15. Post-Circle Do we like what happened?

  16. Who can benefit?(target market) • Patients and physicians who have endured malpractice suit • Seeking closure and healing • Patients and physicians • Proactively ASAP after things go wrong

  17. Who needs to buy in? Risk management CEO Medical staff leadership

  18. Most likely hospitals Self-insured Most/all physicians are employees University and VA hospitals

  19. Funding source Malpractice defense fund

  20. Medical Errors in US 1% of hospital patients About 98,000 die annually Only 30% disclosed to patients Only about 2% of patients file lawsuits

  21. In a world without blame By disclosing and learning from errors, quality of care improves Healing for patients and families; reasonable compensation Accountability and healing for doctors

  22. For more information Dominic Barter, developer of NVC based Restorative Circles, consultant Brazil Ministry of Justice –contact@restorativecircles.org Melinda Zipin, bringing NVC based Restorative Circles to hospitals - melinda@assertivediplomacy.com For emails, please use NVC Restorative Circles as Subject so your email will make it past spam filters.

More Related