When things go wrong - a checklist for doctors

This checklist is designed to be a ready reckoner for what to do when something goes wrong. It should be used in conjunction with the Fact Sheet – Managing unexpected or adverse outcomes.

Communicate

• See the patient and/or their family to explain what happened as soon as possible
• Be honest with your knowledge of the event
• Don’t apportion blame or speculate, for either yourself or others
• Reassure them that you are available
• Be clear with the patient about their recovery timeframes
• What the adverse event means for their ongoing health (transient and permanent impacts).

Documentation

• Patient’s health record
• Hospital or practice forms
• Clear and comprehensive
• Objective.

Apology

• Do not be afraid to say sorry for what happened
• Expressions of regret phrased in the right terms are not admissions of liability.  

Follow up

• Consider other support the patient and family may need and arrange referral
• Consider other intangibles:
  • Waiving any gap fees or additional costs for treatment - see MIGA’s Unhappy patients and the reimbursement or waiver of fees Fact Sheet 
  • Sickness certificates or a letter outlining any anticipated extension time off from work or study
  • Refunds of costs incurred – please speak to an MIGA claims solicitors before considering this
  • Communicate with the patient at all stages and follow up either directly with them or their family or other health practitioners who have taken over care.

Open Disclosure can differ based on the circumstances and that includes hospitals and small practices. The Australian Commission on Safety & Quality in Health Care (ACSQH) provides the following guidelines.
 
ACSQH has published excellent resources on its website and we highly recommend that you refer to them for more information.

Notify

• At an appropriate time, contact MIGA to notify us of the event and to seek advice from our claims solicitors.