Disclosing Unanticipated Medical Outcomes
When there are adverse events and outcomes in a patient’s care, providers’ responses have a powerful effect on all the parties’ ability to communicate about and resolve the situation satisfactorily. Accrediting bodies, professional organizations, state legislatures and research findings all encourage forthrightness when there has been a disappointing outcome.
Effective communication that leads to a satisfactory resolution in these painful situations involves four considerations: the ethics involved, the need for psychological healing, an understanding of legal requirements and the tort system and recognition of the business/economic consequences. To help organizations and individual training professionals develop the perspectives and skills needed to address these considerations, IHC has created a series of programs of varying intensity and depth for practicing clinicians, risk managers, administrators and others who will be involved in helping to communicate about and ultimately resolve these situations with patients and families.
As part of an effort to disseminate effective communication around disclosure and build organizations’ professional development capacity, IHC offers this intensive three-day course for individuals who will teach Disclosing Unanticipated Medical Outcomes (DUMO) workshops. Participants in this DUMO faculty development course may seek certification as IHC faculty members. Only certified IHC faculty members may teach the copyrighted DUMO curriculum.
If you are interested, please pre-register and we will send you information about our upcoming course schedule.
- Duration 3 Days
- Accreditation Approved for CE
- Available To Clinicians, Non-Clinicians
- Course InformationDownload PDF
DUMO is designed for a variety of healthcare professionals who are or plan to become involved in training. Workshops that DUMO faculty will teach are for clinicians in all practice specialties and settings, and for organizational risk managers and administrators who direct the organizational response when adverse events have occurred. It is beneficial for DUMO faculty to have experience in one or more the following areas:
- clinical care
- risk management
- communication training
- workshop leadership
There are four key components to this faculty development course:
- Experiencing the workshop as a participant with a master trainer modeling workshop facilitation;
- Deepening one’s own skills in disclosure and resolution of adverse events and outcomes;
- Developing skills for guiding clinicians and organizations in managing disclosure situations; and
- Practicing workshop facilitation and delivery skills in preparation for leading the 3.5-hour DUMOworkshop independently after an initial observed and coached certification workshop.
DUMO addresses the ethical, psychological, legal and business aspects involved in pursuing a successful resolution with patients and families after unanticipated adverse events and outcomes. Participants learn specific models to guide clinicians in their approach to the disclosure in various situations, for example, where the care was reasonable yet still resulted in an adverse event or outcome; and where there were sufficient problems in the care and the investigation concluded the harm should have been preventable.
The faculty development course content for DUMO includes earning objectives for the DUMO workshop, plus objectives related to teaching the DUMO workshop. Five learning objectives relate to the content of DUMO. By the end of the program, participants will:
- Understand the rationale for greater openness when there has been disappointment with care and possibly injury associated with a medical or systems error.
- Appreciate others’ perceptions of situation (e.g., patients, family, colleagues, staff).
- Consider steps to take before, during and after a disappointing outcome.
- Acknowledge and respond constructively to the emotional and ethical challenges in these situations.
- Practice the disclosure skills in a variety of clinical situations.
In addition, a series of learning objectives relate to participants’ ability to teach the DUMO workshop. Upon completion of this faculty development course participants will be able to:
- Identify and describe the specific behaviors for utilizing the team, selecting an appropriate time for disclosure, selecting appropriate text to be disclosed and appropriate tone to be used.
- Provide examples of research to support the concepts taught in the workshop.
- Modify the script by generating personal examples to further explain concepts taught in the workshop.
- Appreciate the importance of the role of empathy in disclosure.
- Understand the role of workshop facilitator in delivery of the DUMO workshop
- Evaluate their presentation skills and develop a plan for improving performance through follow-up practice.
- Advocate for the importance of effective, ethical communication in disclosure.
- Articulate the teaching points for each slide.
- Set up the interactive exercises by explaining the purpose and procedure for each.
- Utilize effective group facilitation skills.
- Understand the patient’s and family’s thoughts, emotions and needs when adverse outcomes occur.
- Apply two or more interviewing techniques with a standardized patient/clinician.
- Demonstrate effective responses to patient situations presented by workshop participants.
- Respond effectively to each of the video scenarios.
DUMO is an intensive and highly interactive faculty development course, conducted over three consecutive days at a host organization and with 5 to 25 learners. The faculty-to-learner ratio is 1:5 to allow significant attention to individual support and feedback and practice conducting disclosure conversations. All IHC courses are predicated on best practices in clinician-patient communication and emphasize a standard large and small group learning format to provide peer observation, feedback and coaching. Learners practice disclosure and coaching strategies with one another and with “simulated” clinicians (actors). Early in the program we ask participants to identify their own learning objectives. We take this process very seriously and encourage participants to help us understand what they wish to gain from the course.
IHC provides each learner with a completed set of educational materials: a faculty manual (with slide scripts, facilitation guides, teaching strategies and tools), disclosure training video vignettes, annotated bibliography and a carrying bag.
The Institute for Healthcare Communication is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians. The Institute for Healthcare Communication takes responsibility for the content, quality, and scientific integrity of this CME activity. Disclosing Unanticipated Medical Outcomes is designated by the Institute for Healthcare Communication as a continuing medical education activity meeting the criteria for up to 20.5 hours in Category 1 of the Physician’s Recognition Award of the American Medical Association and for nursing continuing education credits.