Study Sees Minimal Barriers for Disclosure, Apology, and Offer Model

January 2, 2013 | Strategic Insights for Health System


Strong support by key stakeholders and minimal perceived barriers would lead to smooth implementation for organizations that choose to adopt a disclosure, apology, and offer model to respond to adverse events, reports a study in the December 2012 issue of the Milbank Quarterly. Authors conclude that “the model holds considerable promise for transforming the current approach to medical liability and patient safety.” (For another perspective, see Disclosure-and-Resolution Programs See Mixed Results, also in the January 2, 2013, HRC Alerts. ) The researchers in this study note that, although patients have the right to full disclosure regarding unanticipated outcomes, it rarely happens in a way that satisfies their need to know what happened and how similar events will be prevented in the future. The model examined in this study includes five steps for organizations to follow: (1) proactive identification of adverse events, (2) differentiating between events caused by negligence and complications of disease or inherently high-risk procedures, (3) full disclosure and an honest explanation, (4) encouraging patients and families to consult with legal representatives, and (5) an apology combined with fair compensation for failing to meet the standard of care.

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