Communicating with patients and families after adverse events. A systematic literature search.
Report
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Key message
Adverse events in healthcare can cause serious consequences for patients, families and healthcare professionals. In this paper, we have performed a systematic search for studies that have examined various aspects of communication between health personnel and patients and their families in the aftermath of adverse events. The purpose of this paper is to provide an overview of the research.
- We included five systematic and two unsystematic reviews. The reviews found that involvement in an adverse event in many cases was a tough experience for both patients, their families and healthcare professionals, but that good communication about the incident could lead to less frustration for all parties. Open disclosure about the event was important for both patients and health personnel. Patients wanted to know what had happened and they also wanted to know what would be done to prevent similar incidents in the future. Although the patients wanted a sincere apology, they had rarely received sufficient information or an apology after the incident. Healthcare professionals felt that they lacked the skills to communicate well enough with the patient and that they themselves needed support, training and firmly anchored communication guidelines. Many feared that transparency about the incident would lead to legal consequences. Some studies summarised in the reviews found evidence that openness could decrease the amount of law suits and patient claims but on the other hand some studies did not find evidence for this connection.
- The reviews pointed out the need for more research on the effects of various interventions, such as communication training and guidelines for patient communication.
- We included 47 primary studies published as of 2009. The results of the studies were not summarised.
We have limited the search to published international research literature and the transfer value of international studies may be limited. To identify the needs of Norwegian patients and what interventions should be introduced in Norway, it is important to draw on the experiences from the healthcare in Norway and the other Nordic countries.