An error in care. A missed or delayed diagnosis. Are you prepared to disclose these to your patients?
Until recently, many patients never met their radiologist to hear about these highly charged clinical events. That’s changing. Today’s patients want to talk with you and your radiology team.
Disclosure and apology conversations after medical error in radiology are among the most difficult for the radiological team. Patients and families may be expressing anger, frustration, and sadness. They may expect their clinicians to take responsibility and convey empathy – even as many radiology teams have no consistent approach to such situations, causing clinicians to often feel defensive, ashamed, unsupported, and unprepared.
Navigating the aftermath of a medical error requires specific skills and preparation. Your team is best served by establishing an internal communication process for a disclosure conversation with patients and families. Concurrently, trained clinicians will be able to engage confidently and compassionately with the patient while lessening their moral distress.
Designed BY radiologists specifically FOR radiologists, this workshop will outline the ethical underpinnings, legal and risk management perspectives, important recent developments, and nationally recommended best practice standards around error disclosure.
Highly recommended for radiology department/team leaders, training managers, and risk managers (both practice- and insurer-based) as well as individual clinicians.
What radiology professionals will learn:
- The basic ethical, legal, and risk management principles, barriers, and challenges specific to radiology, through case-based discussion;
- What an internal communication process should look like, to prepare for disclosure conversations with patients and families, through review of best practices and models;
- Skills for approaching the conversation, anticipating responses and emotions, and re-establishing a positive relationship for next steps in care.
Who should attend
- Radiology department and team managers
- Quality & Safety leaders
- Training managers, including those responsible for meeting ACGME guidelines
- Radiology physicians, residents and fellows
- Nurses and nurse practitioners
- Physician assistants
- Patient advocates
- Risk managers, including at insurers
Live, moderated online workshop format
Participation in the 2-hour online workshop is through an online video conferencing platform. After opening case-based discussion, we’ll view and discuss three short films illustrating relevant scenarios: a team’s deliberations in the aftermath of a delayed diagnosis resulting from errors, the role of a department leader and an institutional disclosure coach, and a radiologist’s discussion with a family about an interpretive error. IPEP is renowned for its use of actors to bring the full range of perspectives into consideration; this scenario-based format will make nuanced concepts more tangible. Using our interactive platform, including our guided whiteboard and comment-board discussions, you’ll be able to engage directly with IPEP’s faculty and your peers from around the country and the globe to learn, discuss, and practice strategies for disclosure.
Enrollment is capped at 50 participants in order to offer everyone the opportunity for input and questions during discussion and Q&A sessions.
Learn from Harvard Medical School experts in radiology, bioethics and communication:
- Stephen D. Brown, MD, Director, Institute for Professionalism & Ethical Practice, Boston Children’s Hospital; Associate Professor of Radiology, Harvard Medical School; Chair of the Professionalism Committee of the Radiological Society of North America (RSNA).
- David Browning, MSW, LICSW, Senior Scholar and Co-Founder, Institute for Professionalism and Ethical Practice, Boston Children’s Hospital.
Find video recorded interviews with national experts covering a wide variety of issues related to Disclosure and Apology, including institutional perspectives and processes, just culture, peer support, and provider and patient perspectives. Hear from Beth Ullem Daly, Dr. Robert Truog, Dr. Jo Shapiro, Dr. Lucian Leape and many more.
View additional videos in our VIDEO GALLERY
Guidelines for Disclosure after an Adverse Event
Read the Guidelines for Disclosure after an Adverse Event
Developed by CRICO in conjunction with the Institute for Professionalism and Ethical Practice
Key Articles about Apology and Disclosure in Medicine and Radiology
Stepping out further from the shadows: Disclosure of harmful radiologic errors to patients
Brown SD, Lehman CD, Truog RD, Browning DM, Gallagher TH., Radiology 2012; 262:381-386.
Patients’ and Physicians’ Attitudes Regarding the Disclosure of Medical Errors
Gallagher TH, Waterman AD, Ebers AG, Fraser VJ, Levinson W., JAMA. 2003 Feb 26;289(8):1001-7.
Disclosing Harmful Mammography Errors to Patients
Gallagher TH, Cook AJ, Brenner RJ, Carney PA, Miglioretti DL, Geller BM, et al., Radiology 2009 Nov;253(2):443-52.
The Mea Culpa Conundrum
Leonard Berlin, MD, Radiology 2009; 253:284–287
Radiology trainees’ comfort with difficult conversations and attitudes about error disclosure: Effect of a communication skills workshop.
Brown SD, Callahan M, Browning DM, Lebowitz R, Bell SK, Jang J, Meyer EC. The Journal of the American College of Radiology 2014; 11(8):781-7.
Implementing communication and resolution programs: Lessons learned from the first 200 hospitals
Timothy B McDonald, Melinda Van Niel, Heather Gocke, Journal of Patient Safety and Risk Management, 2018, Vol. 23(2) 73–78.
The Reality of Disclosure Conversations, by Dr. Robert Truog, Director of the Center for Bioethics at Harvard Medical School
- Describe nuances of communicating diagnostic imaging results to patients.
- Recognize how peer review and error disclosure are interconnected.
- Weigh risks and benefits of error disclosure in practice.
- Explain the rationale for direct radiologist-to-patient disclosure of radiological errors.
- Discuss how to avoid getting into a claim or lawsuit.
- Discuss the legal assessment of a missed finding.
- Discuss best practices to protect the peer review process.
- This enduring material is estimated to take 1 hour to complete.
In support of improving patient care, Boston Children's Hospital is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for the healthcare team.
Boston Children’s Hospital designates this live activity for a maximum of 2 AMA PRA Category 1 Credits ™. Physicians should claim only the credit commensurate with the extent of their participation in this activity.
AAPA accepts AMA category 1 credit for the PRA from organizations accredited by ACCME.
Boston Children’s Hospital designates this activity for 2 contact hours for nurses. Nurses should claim only the credit commensurate with the extent of their participation in the activity.”