The Transformative Power of Apologies in Healthcare Teams

power of apology, physician holding hand of patient

The High-Stakes World of Healthcare

The healthcare sector is known for its high-pressure, high-stakes environment, particularly in critical areas such as the Emergency Room (ER), Operating Room (OR), and Intensive Care Unit (ICU). These settings are fraught with challenges and the constant potential for errors and misunderstandings, significantly different from the relatively calmer environments of medical wards, laboratories, and radiology departments.

The Inevitability of Errors

A complex healthcare system has many touchpoints with complex machinery requiring up-to-date training and frequent refreshers. We have many people interacting and many chances of miscommunication (children telephone game).  We deal with medications with potential serious side effects and drug interactions that are difficult to remember. Fatigue/long hours and pressure to see more patients in less time decrease the amount of interaction increasing the chance of missing important information. Language barriers and other cultural elements can jeopardize the quality of information.

Mistakes can cause no harm or severe harm, even death. Everybody on the team feels bad, morale suffers, and trust might be lost.  The person(s) directly involved might become the second victim and experience significant mental health problems.

The consequences of errors in healthcare can be severe, affecting not only patient outcomes but also the morale of the healthcare team. Those directly involved in the error may suffer from significant emotional and psychological tolls, becoming ‘second victims’ of the incident.

The Power of Apology

When errors occur, the aftermath can be daunting. The initial step of informing the patient and their family about the mistake is critical. Though challenging, admitting responsibility and offering a sincere apology is often the most effective way to mend relationships and avert potential lawsuits.

An effective apology needs to be sincere and empathic by conveying the participation of the person(s) responsible to the pain and suffering of the victim(s). It is important to acknowledge the mistake and as much as possible explain why it happened.

Compassion should be dictating what can be done on the part of the organization to alleviate the consequences (need for rehabilitation, long-term care, etc.).  It is critical to inform the victim(s) that the healthcare system is committed through a focused intervention to prevent the re-occurrence of this error. We firmly believe that the responsible party should not make any excuse and should ask for forgiveness.

Overcoming Barriers to Apologizing

Apologizing is not easy because cultural and systemic barriers make it arduous. From the individual standpoint, acknowledging a mistake is without any question an embarrassing situation for anybody, particularly in the professional world where reputation is a very important asset.  Accepting responsibility requires a significant dose of courage because it exposes the individual(s) to potential sanctions.  

When making an apology, the choice of words, location and time are important, and they can be optimized with appropriate preparation.  From a system point of view, the legal department is very likely to strongly oppose any admission of responsibility for the occurrence of the error even in the most egregious cases for the fear of potential lawsuits. Overcoming these barriers is essential for fostering an environment where apologies are seen as a strength rather than a weakness.

The Anatomy of an Effective Apology

An effective apology needs to be sincere and empathic by conveying the participation of the person(s) responsible to the pain and suffering of the victim(s). It is important to acknowledge the mistake and how you will make it right.

  • Be Sincere
  • Acknowledge the error
  • Be Timely
  • Express Remorse
  • State how you will make things right
  • State how you will prevent it from happening again

Compassion should be dictating what can be done on the part of the organization to alleviate the consequences (need for rehabilitation, long-term care, etc.).  It is critical to inform the victim(s) that the healthcare system is committed through a focused intervention to prevent the re-occurrence of this error. We firmly believe that the responsible party should not make any excuse and should ask for forgiveness.

The Positive Impacts of Apologies

Research and case studies have shown that apologies can lead to improved patient satisfaction and trust, enhanced team dynamics, and a reduced likelihood of litigation.

Despite the legal department position there is published evidence (and it is my direct experience) that admitting a mistake and taking responsibility for the consequences produce multiple important positive results. The honesty and humility revealed by a sincere apology are the strongest boost for resilient provider/patient relationship, which in turn is the strongest protection against a legal claim.  An apology to the patient is an indirect apology to the co-workers for letting down the team; it improves team dynamics and stimulates efforts to improve internal communication and collective mindfulness.

Fostering a Culture of Openness

Encouraging a culture of openness and accountability within healthcare organizations is crucial. Leadership plays a key role in modeling appropriate behavior, and training programs focused on communication and empathy can further support this endeavor.

It has been my experience that it is the leader’s responsibility to model a culture of openness and accountability is paramount to the creation of a just culture. I know of a CEO that took responsibility and apologized to the family of a young patient who suffered irreversible brain damage dure to a tragic error.  I personally trained employees and contractors of a large healthcare organization and witnessed the dramatic incremental improvement of all the KPI linked to QUALITY Safety, Timeliness, Efficacy, Efficiency and Person-centeredness (STEEP). 

The Importance of Apologies in Healthcare

Apologies in healthcare are not just about saying “sorry” but are a fundamental component of improving patient care, strengthening teams, and creating a more humane healthcare environment.

Key points you can take away from this post:

An Apology starts with the acknowledgement of an error, which is critical to the improvement process.
An Apology is much more likely to preserve and protect a patient/provider relationship and avoid legal claim.
An apology helps the team build a stronger team dynamics /collective mindfulness.

If your healthcare team is looking to navigate the complexities of high-stakes environments with grace and develop a culture where apologies serve as a bridge to better patient care, I am here to help. Embrace the opportunity to enhance team dynamics, patient satisfaction, and overall healthcare quality. Click here to schedule your strategy session and take the first step towards a more compassionate and effective healthcare environment.