When Things Go Wrong: A Patients Perspective

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When Things Go Wrong A Patients Perspective

• Linda K. Kenney
• President/Executive Director
• MITSS-Medically Induced Trauma Support Services
• Friday, April 20, 2007

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November 18, 1999

• Limited information in hospital
• Limited family support in hospital
• No support after discharge
• No follow up communication

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What Patients/Families Want Following Adverse
Events

• Transparent communication in real time
• An Apology or an acknowledgement
• Organizational response to prevent recurrence
• Support (unique for each individual)

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Barriers to Change

• The Clinician as Super Human
• Hippocratic Oath First Do No Harm
• Shame, humiliation, and incompetence
• Culture of fear around medical-legal action
• The emotional discomfort around events

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How Many are Affected by Medical Error?

• Deaths due to medical error 98,000/yr
• Affected family members gt 196,000/yr
• Affected clinicians gt 196,000/yr
• Patients injuries per year in the US 15 million
  (IHI Data)
• Affected family clinicians per year gt 30
  Million
• Total affected At least 50 Million

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• We know these things happen even in the safest
  systems then why dont we have support mechanisms
  in place for patients, families, and clinicians
  following adverse medical events?

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MITSS Founded in June 2002(Medically Induced
Trauma Support Services)

• Mission
• To Support Healing and Restore Hope
• Purpose
• To create awareness and to provide open
  support services to ALL affected by adverse
  medical events

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What is Medically Induced Trauma?

• Medically Induced Trauma is an unexpected outcome
  that occurs during medical and/or surgical care
  that affects the emotional well being of the
  patient, family and/or clinician.

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Medically Induced Trauma is Unique

• Patients and Families may feel
• Isolated, because hospitals often are not set up
  to provide emotional support beyond the hospital
  stay
• Breach of trust between caregiver and patient
  that is so crucial to recovery
• Vulnerable, since, in most cases, the patient
  will need continued care within the same system
  that harmed them.

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Emotional Effects Immediate or delayed

• Depressed mood, irritability, loss of interest or
  pleasure
• Sleeping or eating difficulties
• Drug or alcohol abuse
• Feelings of inadequacy
• Loss of trust
• Perceived indifference from caregivers
• Anger, guilt, frustration
• Inability to think or concentrate
• Recurrent images or thoughts of the event
  triggered by non specific events
• Desire to connect with others experiencing
  similar trauma
• Feeling isolated and alone

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MITSS Services

• Awareness and Education
• Advocacy for Action
• Direct Support Services

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Advocacy for Action

• Infrastructure for internal support systems for
  care providers. (MITSS is the only outside
  organization participating on the Peer Support
  Task Force at the BWH)
• Full disclosure, apology, and support following
  adverse medical events
• Emotional support for patients and families
  during hospitalization and following discharge
• Partnerships with healthcare organizations

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Direct Support Services

• Support Groups
• Patients and families
• Nurses
• MITSS Website www.mitss.org
• Toll Free Hotline (1-888-36MITSS)
• Early Support Activation BWH Social Services

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MITSS Long-term goals

• Institutional advocacy for full disclosure,
  apology and support
• Community outreach
• Implement best practices of emotional support
• Referral processes with healthcare organizations
  for continued support following discharge
• Replicable MITSS model of support
• Information clearinghouse for best practices

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They didnt know it was impossible so they went
ahead and did it

• -Mark Twain