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Communication among Medical Staff

It’s important not to overlook the impact of adverse events on the care team itself. Anyone involved in an error resulting in harm to a patient is likely to be affected, though their individual experiences and reactions may vary considerably. Health care provider organizations will want to have policies and procedures in place to ensure internal communications are prompt and effective when an adverse event occurs.

How can our organization offer support to the care team?

Use the following approach when communicating with colleagues:

  • Let colleagues share their experience
  • Be patient and allow for silence
  • Express appreciation for sharing
  • Reflect, interpret, and summarize
  • Discuss coping strategies
  • Inquire about the colleague’s support systems
  • Provide a resource list if possible (check with your Employee Assistance Program)
  • Ask permission to follow up, and get their preferred contact information
  • Ask: Are you going to be okay?

When in doubt, refer.

How will we know if a member of our care team is struggling in the aftermath of an adverse event?

Team members may have different reactions. Here are some signs to watch for:

Psychological and Emotional

  • Depressed mood
  • Irritability
  • Loss of interest or pleasure
  • Drug or alcohol abuse
  • Feelings of inadequacy and loneliness
  • Loss of trust
  • Perceived indifference from colleagues
  • Anger, guilt, frustration Inability to think or concentrate
  • Recurrent images or thoughts of the event triggered by non-specific events
  • Distress when exposed to events that are reminders of the trauma
  • Hypervigilance
  • Desire to connect with others experiencing similar trauma

Cognitive

  • Inability to think or concentrate
  • Feeling distracted

Physical

  • Trouble eating or sleeping
  • Fatigue
  • Headaches

Behavioral

  • Hyperactivity, or less activity
  • Drug or alcohol abuse
  • Social isolation
  • Insomnia or excessive sleeping
  • Strong need to talk about the event or read information surrounding the traumatic event
What are key elements of effective support for clinicians and staff?

All health care organizations can be prepared to provide emotional support to their clinicians and staff members following an adverse event. Here are some thing to know or to do:

• Increasingly, hospitals and large health systems have programs or resources that can help. Be sure individuals in your organization know how to access help in the immediate aftermath of an event.

• Clinician and staff support is most successful when it is part of an institution’s operational response to adverse events.

• Be observant and flexible about needs. Never assume that individuals whose involvement may seem peripheral are okay; they, too, may be experiencing stress or more. Similarly, try not to prejudge what constitutes an “adverse” event.

• Pay special attention to the needs of clinicians and staff who will be leading disclosure conversations with patients and families. They will be more effective if they, too, feel supported.

• Fear of legal action should not prevent someone from getting the emotional support they need following an adverse event. While clinicians need to avoid discussing the details of the medical case outside of privileged communications with legal counsel, they may talk about their feelings without fear that those discussions will be used against them in court.

Where can we get help building a support program for staff?

The Betsy Lehman Center is working with hospitals and health systems across Massachusetts to establish peer support programs tailored to their unique needs. Click here more information about this program or to contact a member of the peer support team.

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