Journal Article

Disclosure, apology, and offer programs: stakeholders' views of barriers to and strategies for broad implementation.

Bell SK, Smulowitz PB, Woodward AC, et al. The Milbank quarterly. 2012;90:682-705.

Some hospital systems have employed a disclosure, apology, and offer strategy for medical errors, with the University of Michigan program being the best described. This model includes full disclosure of adverse events, appropriate investigations, implementation of systems to avoid recurrences, and rapid apology and financial compensation when care is deemed unreasonable. Researchers for this study interviewed key stakeholders and found strong support for more widespread implementation of this model, despite a lack of generalizable data. Benefits for both the liability system and patient safety were discussed, along with substantial challenges to implementation. However, none of the barriers described were felt to be insurmountable. Dr. Albert Wu discusses adverse event disclosure and apologies in an AHRQ WebM&M perspective.