Restoring Trust: Improving the quality of response after healthcare harm

Healthcare is a risky business. While the maxim ‘first, do no harm’ is a fundamentally important precept, and the aim of a ‘zero harm’ care environment is a laudable one, no healthcare system will ever be completely harm free. How the needs and interests of patients and professionals are managed in the aftermath of healthcare harm is therefore a significant, but largely overlooked, aspect of care quality.

In this brief presentation, I drew on my work with patients, families and professionals (www.patientstories.org.uk) and my colleague Dr Suzanne Shale’s research into the moral experience of NHS medical directors (published as “Moral Leadership in Medicine: Building Ethical Healthcare Organisations” Cambridge UP 2012)

I introduce seven “standards” or “ethical practices”, that can be used as a set of quality criteria to improve the overall quality (effectiveness, safety and experience) of response after healthcare harm.  This work is also published as Anderson-Wallace,M. & Shale, S. (2014) “Restoring Trust – Improving the Quality of Response after Health care Harm”  Clinical Risk” (Sage/RSM) ISSN 1356-2622 Vol 20 No1-2 Jan/Mar 2014

Sir Robert Francis QC comments of the work as follows:

“Murray Anderson-Wallace and Suzanne Shale propose a set of standards which should be followed when harm has been caused in a healthcare setting to a patient. They point, rightly, to the impact that such potentially devastating events have not only on patients but also on the staff involved. Creating the right conditions for patients to be told the truth about what has happened to them while supporting and encouraging the staff who have to ensure this happens, and to learn the relevant lessons for the future will always be challenging. A consistent set of standards of quality for the handling of the aftermath of such incidents would be helpful. Such standards recognise that the handling of the aftermath of treatment is just as much a part of the service provided to the patient as the treatment itself. As such poor incident handling is also liable to cause harm to patients and those around them”