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Informing Patients/Families of Unanticipated or Unexpected Outcomes. Unanticipated outcomes cont…. The requirement to disclose unanticipated outcomes is an affirmative obligation, which, like prospective disclosure of risks, emanates from patient autonomy and the patient’s right to know.
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Informing Patients/Families of Unanticipated or Unexpected Outcomes
Unanticipated outcomes cont… • The requirement to disclose unanticipated outcomes is an affirmative obligation, which, like prospective disclosure of risks, emanates from patient autonomy and the patient’s right to know. • Covering up errors is not permitted.
What disclosure should include • Timely disclosure should include: • What happened • The causes, if known • Any known effects on the patient's short term and long term health • Only clinical information regarding the occurrence is to be documented in the patient’s medical record.
The disclosure process • An attending or their designee should inform patient and/or families of the unanticipated outcome(s) as soon as reasonably possible, either: • Within 2-3 hours of the occurrence or the recognition of such; • Within the same shift or the occurrence or its recognition. • As reasonably possible, the same individual should communicate with the patient/family.
The disclosure process cont… • If possible a single individual, either the patient or family member, should be identified as primary contact for (daily) communication. • The disclosure and ensuing conversations should take place in a location that assures patient privacy and confidentiality.
The disclosure process cont… • Given that the issue of disclosing unanticipated outcomes requires a coordinated institutional response, the provider should contact risk management prior to patient/family disclosure.
Related Policy • For policy related to Sentinel Events, see “Sentinel Events” policy on Gradynet.