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Health Policy and Management

Removing Insult from Injury: Disclosing Adverse Events

Version 1.1 Now Available!

There is an obligation for physicians and hospitals to disclose adverse events. However, it is difficult to admit making an error, particularly one that harms a patient. This difficulty is compounded by lack of training on the subject.

Researchers at the Johns Hopkins Bloomberg School of Public Health are working to help educate physicians in how to disclose medical errors to their patients and their families. They've developed a 25-minute training video, Removing Insult from Injury: Disclosing Adverse Events. The video features short vignettes of doctors talking with patients to illustrate the best methods for disclosing medical errors. Removing Insult from Injury: Disclosing Adverse Events can be a helpful tool for practicing physicians and physicians in training, risk managers and health care organizations. View the preview trailer hereClick here for ordering information

(Free Real media player required to view videos)

Selected Vignettes

These vignettes, along with three others, are included in Version 1.1, now available.

[Caution: these scenarios are very abbreviated.  No discussion of this nature can be made properly in only two minutes.]

Chemotherapy Overdose 

Chemotherapy Overdose: Sincere Apology (2:08)      

In this case, the doctor must tell Mr. Smith that his father’s hospitalization is due to an overdose of chemotherapy, after she miscalculated the dosage.             

Pediatric Surgery  

Pediatric Surgery: No Apology (1:42)

In this case, the surgeon must explain to Ms. Brown why he did not respond to a series of pages about her son’s deteriorating condition.  Perhaps due to the delay, the child codes and is rushed to surgery.

Pediatric Surgery 

Pediatric Surgery: Apology (2:30)

In the second version the surgeon apologizes and accepts responsibility for the incident.

Ordering Information

Version 1.1 package of Removing Insult from Injury: Disclosing Adverse Events is now available. The package includes the 25-minute video in both DVD and CD formats.  The CD and DVD come in a three-ring binder with the Facilitator Guide which provides additional information on disclosure and provides suggestions for use of the materials.  Accompanying the video on the CD are 6 sample vignettes (examples are above) and the facilitator guide in PDF format.  To order by check, click here for a fillable PDF version of the order form.  For questions or to order by phone, contact Joyce Hines at 410-614-5089 or by email.

Institutional licenses of Version 1.1 of Removing Insult from Injury: Disclosing Adverse Events are available. Contact Rachel Jones for details at 410-955-6926 or by email.

Funded by MCIC Vermont, Inc. and the Agency for Healthcare Research and Quality.

Helpful links:

The Intensive Care Unit Safety Reporting System Project
The Intensive Care Unit Safety Reporting System is a project to improve patient safety in intensive care units. The site includes an anonymous web-based reporting system in a national cohort of ICUs. 

Agency for Healthcare Research and Quality (AHRQ)
AHRQ is the lead government agency for patient safety. Patient safety may be found in the “Quality Assessment” section.

Josie King Pediatric Safety 
Josie King was the beloved daughter of Tony and Sorrel King.  She died at the age of 18 months as a result of hospital errors. Through the creation of a patient safety program, the King’s hope to prevent this from ever happening to another child.

This American Life   
Apologizing for medical errors was discussed on the November 5, 2004 episode of the NPR radio show This American Life
. Listen to the program here.