Health

HEALTH • Spring 2015 23 A shot of healthy marketing! DON'T MISS OUT! You'll want to see and be seen in this new publication! While the health care industry in our region is huge, there has never before been a single resource that delivers both industry news and analysis along with a consumer forum where industry experts can share their best advice and insights. Our new regional HEALTH publication and E-newsletter will be aimed not only at health care professionals, but at health-care consumers, both retail and business. If you're a player in the health care field looking to promote your service, or if your business is trying to reach medical professionals and practices with products or services - we can help you deliver your message to this highly targeted audience. UPCOMING ISSUE DATES: • JUNE 15 The Future of Health Care/Fitness & Nutrition • SEPTEMBER 21 Health Care Careers/Cancer Care • OCTOBER 26 Annual Health Care Resource Guide • NOVEMBER 30 Mental & Behavioral Health/ The Business of Health Care For information on how to get your company's message in front of this highly targeted audience, contact Mark Murray, Associate Publisher at 508.755.8004 x227 or mmurray@wbjournal.com The Region's Quarterly Health Care Magazine HEALTH C E N T R A L M A S S A C H U S E T T S How to say 'sorry' to a patient? I n 2012, the medical care of Massachusetts residents was trans- formed by the liability reform pro- visions of Chapter 224, the state health care reform law. Also known as the "sorry law," it requires full disclosure, apology, and compensation, if appro- priate, in a fair and timely fashion when medical errors, such as mistakes during surgery, occur. The legislation also makes the ordeal of malpractice litigation a last resort, which benefits both patients and caregivers. In cases that proceed to litigation, the law makes any state- ments of regret, error, apology or concern by a health care provider to a patient about an unanticipated out- come inadmissable as evidence in court, barring any contradictory or inconsistent statements about facts. The law allows Massachusetts to join a growing number of states in tackling disclosure and apology (also known as D&A) as a path to better, safer and more affordable care. The legislation has helped trans- form the patient-provider relation- ship from one that's sometimes root- ed in fear to one based on mutual trust. It facilitates a shift from the costly and time-consuming practice of "defensive medicine" to an evi- dence-based practice, with lower costs and better outcomes. But where there is change, there is also challenge. Disclosure and apolo- gy skills are rarely taught in our med- ical schools and training programs. Disclosing a medical mistake, and apologizing for it, are not easy, with a range of emotions experienced by patients and their families, as well as providers who may be consumed with guilt, shame and self-doubt. Recognizing this need for formal D&A training, the University of Massachusetts Medical School and UMass Memorial Health Care have taken the lead in developing an inno- vative D&A skills program, designed for health care providers — registered nurses pursuing advanced practice certification, attending physicians, and residents training to be specialty physicians — to master disclosure and apology, consistent with the stan- dards established by the Massachusetts legislation. Our pilot curriculum, introduced in 2014, has been praised by medical and nursing trainees across a wide range of disciplines. The curriculum focuses on principles such as convey- ing empathy while facilitating patient questions and shared concerns, and allows hands-on practice using actors who portray realistic patient encoun- ters. In this simulated setting, learn- ers experience real-world emotions and stresses, through the actors' por- trayals that span the full range of emotions experienced by patients and families: anger, mistrust, guilt, fear, and grief, as examples. Physicians and nurses are observed, so that skills can be prac- ticed with the support of an expert team of coaches, including communi- cations experts, patient-support spe- cialists and risk management consul- tants. Actors provide feedback to stu- dents to reflect on and improve their skills for the benefit of the patient. Students report that the D&A train- ing provides a realistic, powerful and essential learning experience. For patients and their caregivers, the legislation has fundamentally changed the experience of unintend- ed adverse medical outcomes, trans- forming the patient-provider rela- tionship from adversarial to advoca- cy-based. Through formal D&A training, our health care providers will deliver on the promise of the legislation and be well prepared to promote healing when things go wrong. As a profes- sion, we must continue these efforts. Our patients deserve no less. Dr. Michele Pugnaire is senior asso- ciate dean for educational affairs at the University of Massachusetts Medical School, where she is also exec- utive director of the Interprofessional Center for Experiential Learning and Stimulation. Other contributors to this column include: Dr. Anne Campbell Larkin, associate professor of surgery and assistant dean of Graduate Medical Education and Susan N. Tarrant, senior director of Patient and Family Relations, both at UMass Medical School; and Dr. Stephen E. Tosi, chief medical officer, UMass Memorial Health Care. HEALTH CARE INNOVATION By Dr. Michele Pugnaire

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