June 2014
CLEAR program offers disclosure and apology

About five years ago, evidence emerged that disclosure and apologies in the face of unexpected clinical outcomes can help patients, families and clinicians heal. YNHHS developed a working group called Responding to Unexpected Clinical Outcomes (RUCO) with representation from Bridgeport, Greenwich and Yale-New Haven hospitals, Yale School of Medicine, Northeast Medical Group, nursing and MCIC, YNHHS’ malpractice insurance company. The group looked at best practices at other academic medical centers and developed a new program called CLEAR – Communication Leads to Early Resolution.

CLEAR offers resources for clinicians who have a patient with an unexpected outcome – how to approach patient or family, what to say, and an understanding of why disclosure and an apology is generally the right action. Using the YNHHS SYN:APSE simulation training center, more than 60 hospitalbased “disclosure coaches” – primarily physicians and some nurses – have been trained throughout the system to assist clinicians in these conversations.

If a member of the Medical Staff needs help, information about the CLEAR program (Disclosure/Apology) is posted on the Legal and Risk Services page of the YNHHS intranet. Go to the YNHHS intranet, click on departments/Legal and Risk Services/FAQs or visit www.ynhhs.org/legal-guidelines and you will find several CLEAR-related resources, including a list of disclosure coaches’ names and a PDF handout about the CLEAR program. You can also call YNHHS Legal and Risk Services at (203) 688-2291 for help or with questions.

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