Mar. 13, 2008 at 2:29pm

Asking yourself the questions you hope you are never asked

Posted by Kathleen Deakins in Internal Communications, Media Relations
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You know what they are after when the crisis hits: What happened? What caused it? What does it mean?

Like you, we often prepare for questions from the media, employees and the anxious and the curious by asking ourselves the tough questions and then drafting answers before they are asked. Vincent T. Covello, Ph.D., long-time counselor to government and industry facing environmental hazards, gets a head start by pulling out a standard list of 80-odd questions he created.

Great idea, we think. So with a nod to Dr. Covello, we got to work on a list for hospitals dealing with an adverse event.

Review our list and add to it – and let’s hope you’ll never need it.

     The incident

1. What happened?
2. When did it happen?
3. Where did it happen?
4. Who was hurt?
5. How did this happen?

   The patient

6. How is the patient now?
7. Is the patient out of danger?
8. How is the patient being treated?
9. Who is treating the patient?
10. Will the patient recover?
11. Are or were other patients at risk?
12. How do you know if other patients are at risk?
13. What lasting effects will the patient suffer?
14. Why was the patient in the hospital originally?
15. What would the normal recovery time have been for the patient when originally admitted?
16. How long was the patient in the hospital?
17. Can we talk to the patient?
18. Have you notified the patient’s family?
19. What have you told the family?
20. How did the family react to the news?
21. Can we talk to the family?
22. Will the family sue the doctor/nurses/technician?
23. Will the family sue the hospital?

    The medical staff

24. Who was responsible for the patient’s care when he or she was hurt?
25. When was the injury/error/problem discovered?
26. Who discovered the injury/error/problem?
27. Who is to blame?
28. Do you accept responsibility for what happened?
29. Were standard hospital procedures followed?
30. Were doctor’s orders followed?
31. Was this a medication error?
32. Specifically, what was the medication error? Wrong dose? Wrong medication?
33. Does the hospital have computer order entry for medications?
34. Could this incident have been avoided?
35. Were you surprised that this could occur?
36. Could this problem have been detected earlier?
37. Was the incident reported to the authorities? To whom?
38. Were any laws broken?
39. What do you know so far about the cause injury/error/problem?
40. Will there be an investigation?
41. Who will conduct the investigation?
42. When will the results be known?
43. Will the results be made public?
44. Is the conduct of the doctor/nurse/technician in question?
45. What about the conduct of the doctor/nurses/technician is in question?
46. Is the doctor/nurse/technician still on the job?
47. Will the doctor/nurse/technician be disciplined?
48. How many similar incidents has the doctor/nurse/technician been involved in resulting in harm to a patient?
49. Can we talk to the doctor/nurse/technician?
50. Can we talk to someone with medical expertise in this kind of case?
51. Why wasn’t this prevented from happening?

    The hospital

52. How much will this patient’s care cost the hospital?
53. What is the hospital’s safety record?
54. What is the hospital’s quality rating?
55. What is an “adverse event?”
56. What is a “never event?”
57. What does it mean that it is a “system problem?”
58. What does it mean to have a “blame-free environment?”
59. Are you hiding behind patient confidentiality regulations?
60. Are you hiding behind employee confidentiality policies?
61. Has the hospital participated in the 100,000 Lives or 5 Million Lives campaigns? Why or why not?
62. Are you self-insured?
63. What would you like to say to your patients and the community about this incident?
64. How does the public know it is safe to come to your hospital?
65. Have you told us everything you know?
66. Is there anything else you’d like to say?

    Has it happened before?

67. Has this ever happened in your hospital before?
68. When was the last time this happened?
69. What caused the incident last time?
70. What happened to the patient last time?
71. How is that patient now?
72. Who was responsible for that patient’s care?
73. How many similar incidents have there been at your hospital?
74. What makes the incidents similar? What is the pattern?
75. What lessons did you learn from that?
76. What changes were implemented?
77. How could this have happened again?

    What happens next?

78. What can be done now to prevent it from happening again?
79. Will you be changing policies or procedures as a result of this incident?
80. Why didn’t you make these changes to policies or procedures earlier?
81. Will this increase your malpractice insurance premiums?

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