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.
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 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 DUMO workshop independently with feedback and support of IHC Senior Trainers and small group facilitators.
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 course content for DUMO includes learning objectives for the DUMO workshop, plus objectives related to teaching the DUMO workshop. Six learning objectives relate to the content of DUMO. By the end of the program, participants will:
- Understand the rationale for greater openness,
- Appreciate others’ perspectives and needs,
- Review the qualities of an effective disclosure,
- Recognize how determining the causes of an adverse outcome informs the path to resolution,
- Identify skills for engaging in effective disclosure conversation with patients and families, and
- Practice the disclosure skills in a variety of clinical situations.
Additional learning objectives relate to participants’ ability to teach the DUMO workshop. Upon completion of this faculty 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 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.
Throughout the DUMO faculty course, IHC Senior Trainers and small group facilitators provide feedback to learners and assess their readiness to conduct DUMO workshops. In the event that additional support and coaching is needed prior to teaching a DUMO workshop, IHC Senior Trainers are available to provide such personalized support and guidance. Individualized support is scheduled separately and subject to additional fees.
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 (IHC) takes responsibility for the content, quality and scientific integrity of this CME/CE activity. IHC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Institute for Healthcare Communication designates the 3-day Disclosing Unanticipated Medical Outcomes (DUMO) faculty course for a maximum of 20.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing education (CE) credit may be available to non-physician participants. IHC will provide a certificate of completion, which can be submitted to learners’ respective accrediting organizations. IHC is pleased to provide any necessary documentation to help learners gain CE credits for completion of this activity.