OnMedica – News – Bereavement service led by senior clinicians could reduce risk of litigation after patient deaths

The participation of specialists, matrices and concerned quality and safety managers is essential to reduce the risk of prosecution at the hospital

Hospital-based mourning services led by experienced physicians and nurses, as well as the Quality and Safety Officer, can help to limit patient complaints and legal proceedings following the death of this patient. results of a pilot study * conducted in one of the SSN hospital trust and published online in the newspaper BMJ Palliative and supportive care.

Families who use hospital bereavement often do so because they have unanswered questions about the diagnosis or treatment of the deceased and / or the quality of care provided, the researchers said. Complaints and court 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 rule out the likelihood that the same incident happens again.

The researchers examined the impact of the Medway model in which loved ones are contacted the business day following the death of their loved one and invited to a semi-structured one-hour meeting at the hospital with the competent medical specialist and the matron in which the patient died. . Meetings are held earlier if the death is being investigated, to reduce the coroner's workload and to 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 surgical head of the hospital writes an official report of the quality and safety, and the measures to be taken are agreed.

One week after the meeting, typed minutes are sent to family members, who are informed of the results of subsequent investigations and outstanding issues, and their reactions (anonymous or positive) are conveyed to all those involved in the proceedings. patient care.

The service was offered to those deceased following surgical procedures between May 2017 and January 2018, during which 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 rebadure that other patients would not have to live through what they had 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 this service reported that they had closed, while the rest were expecting additional information that was not available at the meeting.

The researchers said, "Many other models [of bereavement care] appear to offer 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.

"In our opinion, families should not have to defend themselves or complain for answers or express their concerns about the death of a loved one. They should have the right to access it through hospital services ".

The study was an badessment of the mourning service of a hospital trust. "Further research is needed to determine if such a service, if it was deployed nationwide, would reduce the costs for the NHS related to complaints and litigation," the researchers said.

* Grimes CE, Stringer B, Roberts-Jones L. Simple and powerful: a counseling and grief management service led by governance. BMJ Palliative and supportive care. Posted online for the first time: January 10, 2019. doi: 10.1136 / bmjspcare-2018-001661