PROVO, Utah -- Medical mistakes are the bane of millions of well-intended health care professionals who are working to fool-proof their systems and practices. In support of National Patient Safety Awareness Week (March 6-12, 2005), VitalSmarts has released results from a new study that suggest patients often play an unwitting role in bringing about these mistakes by not confronting their healthcare practitioners.
The study identified patients who had recently encountered problems from
feeling mistreated by healthcare practitioners, to feeling worried their care
provider was making a significant mistake. It found patients usually say
nothing about their concerns -- and their silence puts them at risk for
significant personal harm.
"Patients often find themselves in a quandary, worrying their health care
professional is acting on poor information," says Joseph Grenny, author of the
study and president of VitalSmarts. "The patient feels they have to choose
between being respectful and sharing their concerns. Given these two choices,
they don't speak up."
The survey found:
* Less than half of patients spoke up when the caregiver was unclear
about the diagnosis, treatment options or next steps.
* One in five of these people have suffered "substantial" health
problems as a result of not speaking up.
* When patients believed the care provider was making a medication
error, they were more inclined to speak up -- yet more than a third
"The key is to be candid without being offensive," says Grenny. "People
worry about speaking up because they don't want to cause offense. We've spent
more than 10,000 hours watching people who know how to respectfully handle
these crucial conversations."
Grenny says there are some simple communication skills patients can learn
to step up to crucial conversations with their care providers and avoid
* You are the expert. Realize you have important information about your
past experiences, your current symptoms, etc. that your medical
professional desperately needs to make informed decisions. You are
the expert -- and should not defer by assuming the caregiver knows
* Speak up early. Often we wait to speak up until we are so angry we
end up offending our caregiver. Speaking up sooner when you are less
upset, worried or angry, will inevitably yield better results. If you
are already angry or upset, remind yourself this is probably a harried
professional who is doing their best under the circumstances. Then
open your mouth in a way that helps them rather than insults them.
* Show respect. Your doctor or nurse feels "unsafe" when they believe
you don't respect them. This feeling causes them to become defensive
with you. Before describing your concerns, start by affirming your
respect for their competence and position. For example: "I'm grateful
for your attention to me and want you to know that I value your
experience and skill in treating me."
* Share the facts. Caregivers have a hard time with vague statements
like, "Are you sure that's right?" or accusations like "I don't like
the way you're talking to me!" Stop and think about what is happening
that is making you uncomfortable. Look for the concrete facts that
will help the caregiver understand clearly what is bothering you. For
example, "The last time I took this medication I was given a white
tablet to take twice a day. This time it says four times a day and is
a yellow tablet."
* End with a question. Show once again you are interested in the
professional's point of view by ending with a question. "Is this
correct?" or "Why should I not be worried here?"
Grenny's tips are based on his New York Times bestselling book, "Crucial
Confrontations: Tools for Resolving Broken Promises, Violated Expectations,
and Bad Behavior.
Source: VitalSmarts, L.C.