Published January 30, 2025
It’s always difficult to explain when a treatment or procedure results in an unexpected outcome, especially patient harm.
For the past 10 years the Clear Disclosure Program has provided Yale New Haven Health clinical staff with tools, training and support to guide these conversations so patients and providers can begin the healing process when something goes wrong.
“The Clear Disclosure Program is how we communicate unintended outcomes to our patients and families,” explained Scott Sussman, MD, physician executive director, Office of the Chief Medical Officer, Yale New Haven Hospital, and assistant clinical professor, Yale School of Medicine. “We do this to be transparent and build a culture of trust. It’s the right thing to do for our patients and clinical teams.”
Under the program, providers need to promptly communicate what they know with the patient when there is an unexpected clinical outcome. Dr. Sussman explained the discussion is not defensive, and the provider does not speculate, blame others or make promises. The attending physician apologizes that the event occurred, tells the patient the team will review what happened and engages the Patient Experience department.
After the review is complete, which can take weeks, a Clear Disclosure coach meets with the attending physician to prepare for the formal disclosure. The attending and a representative from Patient Experience meet with the patient and family to share additional information and any opportunities for improvement.
The program has evolved since its inception in 2014, with a renewed focus on healing. The change in focus resulted from a program assessment with feedback from patients, families and clinical staff.
Originally, the program was called CLEAR, an acronym for Communication Leads to EArly Resolution. Senior leaders felt “resolution” emphasized the legal aspect of these situations, when the goal is healing for patients, families and clinical team members.
This change illustrates how the Clear Disclosure Program is always evolving to meet patients’ and clinicians’ needs, Dr. Sussman said. Anyone with ideas for the program should contact their leadership.
To start the Clear Disclosure process any time, 24/7, call 475-246-8255 (TALK).
