A CMO's PERSPECTIVE ON DISCLOSURE, APOLOGY AND SUPPORT

Dr. Anthony Whittemore, CMO of Brigham & Women's Hospital in Boston, has been a strong and early supporter of the MITSS mission. When asked about his recent observations and experiences, Dr. Whittemore writes...

During the past few years, medicine as practiced in hospitals has undergone a very significant transition in handling adverse events from a very protective, defensive posture designed to mitigate litigation to a more transparent, non-punitive environment which openly deals with adverse events. Although we have certainly worked to minimize the occurrence of such events, poor outcomes as well as medical errors, the IOM report of 1998 "To Err is Human" certainly catalyzed the process.

Openly admitting that an error has occurred is a difficult task for some moreso than others, and requires support systems that enable clinicians to comfortably discuss the events with patients and their families and to deal with their impact on themselves. As a result, institutions have adopted policies that guide the process of apology and full disclosure and provide support for staff and patients as they deal with the aftermath of a poor outcome or medical error. The net result is a far more comfortable environment, an environment that will never be entirely free from errors, complications and unanticipated outcomes from interventions, but one which openly seeks to improve by learning from each adverse event.

Andy Whittemore, M.D.
Chief Medical Officer, Brigham & Women's Hospital
Professor of Surgery, Harvard Medical School