Shoulder Dystocia Physician-Patient Disclosure

Description

This enduring activity is designed to assist physicians and advanced practice clinicians (APCs) in enhancing their communication skills when disclosing a shoulder dystocia injury to patients and family members. This type of injury to the infant may, unfortunately, occur despite the best of care; however, effective physician-patient communication is an integral part of clinical practice and has been shown to positively influence outcomes by increasing patient understanding and trust.

This program will review a “common” and an “improved” physician-patient discussion following a vaginal delivery with a neonatal shoulder dystocia injury. These discussions will occur immediately following delivery, and at 12 to 24 hours postpartum. We will also gain insight into the steps in the disclosure process from a medical malpractice legal expert.

Description of the Professional Practice Gap (PPG)

When the routine practice of gentle, downward traction of the fetal head fails to accomplish delivery of the anterior shoulder, the impacted shoulder itself or the actions to deliver the infant may result in a traumatic birth-related injury. Failure of the shoulder to deliver spontaneously places both the mother and fetus at high risk for permanent injury. Physicians have a duty to disclose all relevant information pertaining to an adverse event to their patients in a timely manner. Failure to disclose important information may damage the relationship between physicians and their patients. Disclosure of an adverse event with prompt, clear communication helps to maintain physician-patient relationships and improves the rate of recovery through better follow-up. In addition, perceptions by patients and families of physicians hiding information may lead to an increased rate of medical malpractice lawsuits. Patients may feel they need to sue just to get information. Physician simulation and education focus on the safe delivery of the newborn, however, Shoulder Dystocia family meeting preparation and discussion points remain unaddressed.

Learning Outcome Statement

At the conclusion of the program, 80% of the learners will indicate they have improved knowledge of best practices for communicating the events of a shoulder dystocia delivery and newborn follow up to patients and their support person.

Learning Objectives

After completing this activity, learners will be able to:

• Implement one or more changes involving verbal communication that will improve patient perception of the disclosure process.
• Apply non-verbal communication strategies to convey empathy and sympathy for an adverse event.
• Adhere to communication strategies to positively influence outcomes by increasing patient understanding and trust.

Course Developers

David L. Feldman, MD, The Doctors Company
Peter Kolbert SVP, Claim & Litigation Services, The Doctors Company
Shelise Valentine, RNC, MSN, C-EFM, CPPS, CPHRM, Director of Clinical Education, Healthcare Risk Advisors
Kimberly Hathaway, MSN, RN, CPHRM, CPHQ, Director Patient Safety Healthcare Quality & Risk Management, The Doctors Company                                                                                                                           
Johanna Lackner, MPH, MSW, Senior Director, Continuing Professional Development, Department of Patient Safety and Risk Management, The Doctors Company                                                                                                                       

Continuing Education Credit

The Doctors Company is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical educational activities for physicians.

The Doctors Company designates this activity for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

No individual in a position to control or influence the content of this activity has reported relevant financial relationships with commercial interests. No commercial support was provided for this activity.
 

ANCC - Accreditation and Disclosure Statement

The Doctors Company is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

The Doctors Company designates this activity for a maximum of 0.5 nursing contact hour. Learners should claim only the credit commensurate with the extent of their participation in the activity.

No individual in a position to control or influence the content of this activity has reported relevant financial relationships with commercial interests. No commercial support was provided for this activity.
 

Disclaimer

The information and guidelines contained in this activity are generalized and may not apply to all practice situations. We recommend that legal advice be obtained from a qualified attorney for specific application to your practice. The information is intended for educational purposes and should be used as a reference guide only.

Complies with State Requirements

Please SEE the Federation of State Medical Boards overview of Continuing Medical Education requirements by State. 
Please SEE the Registered Nurse and Licensed Practical Nurse CE Requirements by State.

Technical Requirements

The activity is best experienced using the most current browser: Firefox, Chrome, Safari, or Microsoft Edge. Internet Explorer is not supported on this platform. All activities featuring audio must have a speaker. To view graphic images and references that appear in separate "pop-up" windows, JavaScript and session cookies must be enabled on your computer. Adobe Acrobat Reader may be required for certain activities.

Contact Us

If you have questions, contact educationsupport@thedoctors.com or call 800.421.2368.

Resource

Visit our Resource document for this program.