Handling Adverse Outcome: When things don’t go as planned
Retrace Your Steps and Make a Plan to Move Forward
- Document as much detail as possible. This should include:
- Events leading up to adverse outcome
- Treatment conversations and informed consent to include those who were present during the treatment conversations
- Any elements of non-compliance from patient or history of no shows
- The more complex the procedure, the more detail that should be included
- What actions did you take to mitigate the adverse outcome?
- What steps are you now taking to ensure the best possible outcome?
- Communicate effectively and document those communications.
Take a look at Toothnotes’ 10 Tips On Writing Excellent Treatment Notes for more documentation ideas.
- Consider referring. This may include a specialist or transfer to a higher echelon of care.
- Referring is especially important when dealing with pathology, infections, or possible life threatening considerations
- Be empathetic to your patient. If they feel ignored, uncared for, or have reasons to be angry and you don’t address those concerns, the situation will only worsen. The entire office should understand that fires are not extinguished by adding fuel.
- Get help. There are resources available. It’s not a good time to make lonely decisions. There are colleagues, specialists, and other professionals who are willing to help you. Always contact your malpractice carrier if:
- A patient is threatening to report to the state board or file a claim
- Asking for a sizable or unreasonable refund
- Alleging any kind of “below standard of care”
- There were unforeseen or unpredicted issue that occurred during/after treatment
- Treatment did not go as planned and an adverse outcome resulted
- Learn from your mistakes. One way to perpetuate a tragedy is to not learn from it. Ask yourself:
- Was the procedure one that I’m comfortable performing?
- Did I have any reservations prior to the treatment?
- Were there any factors that pressured me into providing a treatment I wasn’t comfortable doing or that I didn’t agree with?
- What steps do I need to take to prevent this from happening again? Communication? Time out procedures? Avoiding distractions?
