Honesty and Transparency, Indispensable to the Clinical Mission-Part I: How Tiered Professionalism Interventions Support Teamwork and Prevent Adverse Events

Michael J Brenner; Richard C Boothman; Cynda Hylton Rushton; Carol R Bradford; Gerald B Hickson

doi:10.1016/j.otc.2021.07.016

Honesty and Transparency, Indispensable to the Clinical Mission-Part I: How Tiered Professionalism Interventions Support Teamwork and Prevent Adverse Events

Otolaryngol Clin North Am. 2022 Feb;55(1):43-61. doi: 10.1016/j.otc.2021.07.016.

Authors

Michael J Brenner¹, Richard C Boothman², Cynda Hylton Rushton³, Carol R Bradford⁴, Gerald B Hickson⁵

Affiliations

¹ Department of Otolaryngology-Head & Neck Surgery, University of Michigan School of Medicine, 1500 East Medical Center Drive SPC 5312, 1904 Taubman Center, Ann Arbor, MI 48109-5312, USA; GTC Quality Improvement Collaborative, Durham, NC, USA. Electronic address: mbren@med.umich.edu.
² Boothman Consulting Group, LLC, Ann Arbor, MI, USA; Department of Surgery, University of Michigan Medical School, Ann Arbor; Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, TN, USA.
³ Johns Hopkins University School of Nursing, Baltimore, MD, USA; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Berman Institute of Bioethics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁴ The College of Medicine and James Cancer Hospital and Solove Research Institute; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus.
⁵ Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Quality, Safety and Risk Prevention, Vanderbilt University Medical Center, Nashville, TN, USA.

PMID: 34823720
DOI: 10.1016/j.otc.2021.07.016

Abstract

At the foundation of clinical medicine is the relationship among patients, families, and health care professionals. Implicit to that social contract, professionals pledge to bring clinical excellence to advance their patients' wellness and healing-and to prevent harm. Patients trust that those privileged to deliver care will do so unwaveringly in service of patients' best interests; however, the incentives and infrastructure surrounding health care delivery can promote or undermine individual performance, teamwork, and patient safety. Modeling professionalism and identifying slips and lapses supports pursuit of high reliability. Part 1, Promoting Professionalism, introduces the first of 3 pillars of advancing the clinical mission.

Keywords: Business of medicine; High reliability; Malpractice risk; Patient safety; Professionalism; Quality improvement; Surgery; Teamwork.

Publication types

Review

MeSH terms

Delivery of Health Care
Humans
Patient Safety
Professionalism*
Reproducibility of Results
Trust*