ICORP GROUP · INSIGHTS
Vulnerable Patients and Disclosure of Clinical Errors in JCI 8: Preparing Hospital Systems
JCI 8th Edition indicates that there is an increased focus on the care of patients with fragility and clinical disagreement. Both issues are directly linked to Patient Rights, Communication, Risk Management and corporate culture.
Vulnerable Patients Not a Single Group
The word vulnerable should be seen from the patient’s ability to understand, make decisions, protect their rights or communicate their own needs. This may vary by age, language, physical condition, mental disability, social status, or context of treatment. The hospital should therefore define a method of systematic identification of special needs.
Risk information should go to the patient.
If the first assessment unit finds a single requirement, but the data is not sent to the next unit. The risk may be repeated. Therefore, it should be reviewed whether Alert, Care Plan and Hand-off help the team see real important information.
Clinical Error Disclosure Requires Non-Personal Process
When there is a disagree. Communication with patients and family is sensitive. The hospital should determine who is responsible, how to coordinate the Clinical Team, Risk, Leadership and Legal/Compliance, and what information should be prepared before the conversation.
Transparency needs to go alongside patient care.
Disclosure of events should not make the patient feel left with difficult information. It should be explained what they know at the time, what the organization is doing and care guidelines to do so by using the appropriate language for the recipient.
After the event, we have to return to the solution.
Clinical Error Disclosure is just part of the response. The event also needs to enter the Risk and Improvement analysis process to prevent recurrence. If the organization communicates well with the patient, the original system has not changed. The risk cycle remains.
Question for internal assessment
- How to identify and identify vulnerable patients?
- Is the specific requirement data transmitted between units?
- Who is the coordinator when a clinical error occurs to communicate?
- Is the team prepared for communication in difficult situations?
- How the event is linked back to improvement?
ICORP can support the review of Patient Rights, Risk Management, Communication Process and JCI Readiness through Gap Assessment, Tracer and Workshop to help hospitals see the gap between policy and practice.
Note: This article summarizes from the issues that JCI announced publicly on 8th Edition does not replace standard guidelines or legal advice in specific cases.