Sorry Works! Helping Healthcare Handle Crises

June 6, 2012
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Doug Wojcieszak is the founder of Sorry Works! , an organization dedicated to helping healthcare professionals, legal professionals, and insurance companies work through crises in the healthcare sector that involve possible malpractice or negligence events. I first heard of Doug’s organization in 2002 when I was doing my master’s research on crisis management. I believe he is making a big difference in helping organizations understand the importance of empathy and communication in what can be very stressful situations. I think you’ll enjoy what he has to say.

1. Tell us a little about Sorry Works! and the history of how it got started.  How did you get involved?

Sorry Works! grew out of personal and professional experiences. 

Personally, I lost my oldest brother Jim to medical errors in 1998, and we experienced the typical cover-up, wall of silence, etc.  We sued and were eventually given a financial settlement, but no explanation of what happened, what went so wrong, and what they were going to do to fix it — a hollow victory. 

Professionally, I have done public relations consulting for both tort reformers and the personal injury bar on the medical malpractice issue.  I learned that both sides were talking past each other and not getting to the true reasons why patients and families file medical malpractice lawsuits, and why doctors and hospitals get sued. 

A little over ten years ago, I started reading some of the early research about the efficacy of disclosure after a medical error.  I saw how empathizing, staying connected, and, when necessary, apologizing and fairly compensating eliminated the need for costly and lengthy litigation – even in cases of serious medical harm, and even death.  This really spoke to me, not only as a patient family member, but also as a political professional.  So, we came up with a term to describe disclosure – Sorry Works! – and put together a website, and launched in 2005. 

Initially, Sorry Works! was a pro-bono project through my PR firm, but it caught fire.  We started getting e-mails and phone calls from hospitals and insurers requesting help and advice on teaching disclosure — and a business was born. Sorry Works! became an LLC in 2007, and we’ve been developing content ever since.  The website receives, on average, 400 unique visits per day, and the e-newsletter has nearly  3,000 subscribers.  Our Sorry Works! book has sold over 20,000 copies, and I have trained thousands of clinicians across the country.   

Sorry Works! is really specialized crisis communication for healthcare professional. Yet, it has such a powerful story to tell.  If sorry can work in the immediate aftermath of medical errors (which is a highly charged emotional environment), imagine what it can do in everyday business situations? It has powerful applications outside of healthcare.

2. What kinds of services/ education components does Sorry Works! provide and who is your target audience?

Our target audience is healthcare, insurance, and legal professionals in both acute and long-term care settings who are concerned about medical malpractice liability.  We reach people every way that they learn, from live introductory presentations and training seminars, to books, booklets, and webinars.  This fall we will be launching a new book entitled “Sorry Works! UP,” which will be a product that helps leaders in healthcare organizations refine and perfect their disclosure programs.  We also anticipate launching additional product offerings geared towards teaching disclosure to front-line staff in acute and long-term care organizations.  Educating front-line staff about disclosure and empowering them is where the action is.

3. Do you know of any research/data backing the idea that apologies/expressing sorrow can lessen litigation numbers and awards?

It’s all over the place – and, in fact, this debate (is disclosure good or not?) is settled.  Sorry absolutely works, not only in reducing litigation but also in making healthcare organizations safer and boosting morale among staff.

The best story I can share is the recent testimony of a soon-to-be-retired risk manager.  This person can tell stories about the bad old days when a family or attorney would call the hospital requesting information, records, etc, and the staff would even deny the patient had been given care.  This risk manager now testifies that disclosure is not only the right thing to do, it’s also good for business.  

4. What do you say to people that are worried that apologizing will leave them open to litigation?

The best way to be exposed to litigation is break the relationship with the injured party, refuse all forms of communication, and don’t be pro-active.   Anger will go through the roof followed by a phone call to the trial lawyer. 

Now, I understand that communicating after something goes wrong is not easy either. In fact, it’s scary.  Most people, especially healthcare professionals, have never been trained much less been encouraged to talk after something goes wrong.  “Shut up!” has been the traditional advice.  So, we need to train people in a thoughtful, intelligent way.  That’s what Sorry Works! has been doing for seven-plus years and will continue to do for the foreseeable future.

5. Is there a situation where you wouldn’t want to express sorrow?

No.  Empathy is appropriate 100% of the time, and it’s okay for everyone to say “sorry” and show they continue to care.  It’s the human thing to do.  Now, we only apologize – admit fault – after a thorough review proves we made a mistake that caused harm.  Even if we have strong hunch, there was a mistake, we wait for thorough, credible review to confirm a mistake.  Wait for the review to be complete before apologizing, but always be quick to offer empathy.

6. What are some of the issues you see that cause resistance to your organization? Legal problems?

When Sorry Works! began in 2005, we had all the debates about the efficacy of disclosure.  Should we do it or not?  Again, that debate is settled.  Now,  the challenges are training, which includes helping front-line staff embrace disclosure, but also helping entire organizations have consistent ethics on all cases, not just the big or easy cases (wrong-side surgery, dosing error, etc). 

How do we handle grey cases, cases that maybe don’t have a large dollar value, or maybe the family doesn’t know something went wrong?  These challenges speak to training and culture change.   So, we have a lot of “blocking and tackling to do,” lots of work to do in the trenches, which, sometimes can be slowed by other priorities and problems. But we will get there.

7. Tell us how lawyers react to your organization?

Quite surprisingly, in a very positive fashion!   Both defense and plaintiff lawyers, as well as risk managers, understand what we are talking about it.  They get it.  These are the folks who deal with cases day in and day out, and they know what drives these cases: poor communication, lack of pro-active behavior, and anger.  And they know what we are proposing addresses all three of these problem areas in a fair, ethical fashion that protects the legal standing of all interested parties. Be quick to empathize and remained engaged post-event, but pause before admitting fault.  Let a thorough and credible review determine if a mistake with causation occurred.  If a mistake happened, admit fault, apologize, and make amends.  If no mistake happened, continue to empathize and offer support.   It’s really common sense, and lawyers get it. 

Find out more about how to plan for crisis in Chris Syme’s latest e-book, Listen, Engage, Respond.

 

 

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