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Hospital mourning services led by experienced doctors and nurses, as well as by the Quality and Safety Officer, can help to limit patient complaints and lawsuits as a result of a difficult death, suggest the results of a pilot study carried out in an NHS hospital. trusted and published online in the newspaper BMJ Palliative and supportive care.
Families who use the bereavement services of hospitals often do so because they have unanswered questions about the diagnosis or treatment of the deceased and / or problems regarding the quality of care provided, according to the authors of l & # 39; study.
Complaints and legal actions are both more likely to occur when family members feel that their questions have not been satisfactorily answered and / or that steps are not being taken to avoid repetition of similar circumstances, they add.
The authors wanted to know if a hospital-based mourning service led by chief clinicians and the quality and safety officer could reduce the risk of complaints, coroner's inquiries and court proceedings, as well as to badist close to coping better with a difficult death.
They used the Medway model under which loved ones are contacted the business day following the death of their loved one and invited to an hour-long semi-structured meeting at the hospital with the competent medical specialist and the matron in which the patient died.
Meetings take place earlier if the death is under investigation, in order to reduce the coroner's workload and better prepare families.
At the meeting, parents are invited to describe their version of events and hope to get answers to their specific problems and concerns. The hospital's surgical manager takes formal minutes to ensure quality and safety, and the actions are approved.
One week after the meeting, typed minutes are sent to family members, who are informed of the results of any pending investigation / issue. And their anonymized reactions (good and bad) are pbaded on to everyone involved in the patient's care.
The service only included deaths resulting from surgery between May 2017 and January 2018, when 121 invitations were sent and 18 families (just under 15%) accepted the offer.
Most (83%) of these families had unanswered questions about the clinical care provided to their loved ones, while more than three out of four (78%) had questions about the quality of care provided. About one in 10 (12%) had questions about both.
The most common clinical topics were related to the management or treatment of their loved one, the timing of investigations, and the fact that something could have saved their lives.
The most common concerns were the quality of nursing care, communication with and between various health professionals and the need to ensure that other patients would not have to live what they experienced.
The badysis of the comment forms showed that almost half of respondents (44%) would have made a formal complaint if they had not been able to get answers to their questions. Questions. Two families had already sought legal advice, but none of them proceeded after the meeting.
Most users (78%) who used the service said they had closed, while the rest were expecting additional information that was not available at the meeting.
Another benefit was the possibility of involving families in the investigation of serious incidents.
"Many other models [of bereavement care] seem to provide counseling or other psychological support, rather than specifically seeking to reduce the number of complaints, investigations and litigation by providing answers to questions or direct discussions on governance issues ", write the researchers .
"We believe that families should not have to defend themselves or complain for answers or concerns about the death of a loved one, they should have the right to access it through the hospital services, "they added.
This pilot study is based solely on surgical cases in a hospital, and thus may not be applicable elsewhere, but it might be worth exploring further, say the authors.
"Further research is needed to determine if such a service, if it was deployed nationwide, would reduce the costs to the NHS resulting from complaints and litigation," they conclude.
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Peer examined? Yes
Type of evidence: pilot study
Topics: People
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