Disclosing large scale adverse events in the US Veterans Health Administration: lessons from media responses

• We examined print, broadcast and social media reports about health care systems' disclosures of large scale adverse events.
• Some components of effective communication (discussion of cause, reassurance, self-efficacy) were more often present than others (apology, lessons learned).
• Media about ‘promoting secrecy’ and ‘slow response’ appeared in reports when time from event discovery to patient notification was over 75 days.
• Health care systems should develop clear messages focused on what is not well covered by the media and shorten the timeframe between event identification and disclosure to patients.

ObjectivesWe examined print, broadcast and social media reports about health care systems' disclosures of large scale adverse events to develop future effective messaging.Study designDirected content analysis.MethodsWe systematically searched four communication databases, YouTube and Really Simple Syndication (RSS) feeds relating to six disclosures of lapses in infection control practices in the Department of Veterans Affairs occurring between 2009 and 2012. We assessed these with a coding frame derived from effective crisis and risk communication models.ResultsWe identified 148 unique media reports. Some components of effective communication (discussion of cause, reassurance, self-efficacy) were more present than others (apology, lessons learned). Media about ‘promoting secrecy’ and ‘slow response’ appeared in reports when time from event discovery to patient notification was over 75 days. Elected officials' quotes (n = 115) were often negative (83%). Hospital officials' comments (n = 165) were predominantly neutral (92%), and focused on information sharing.ConclusionsHealth care systems should work to ensure that they develop clear messages focused on what is not well covered by the media, including authentic apologies, remedial actions taken, and shorten the timeframe between event identification and disclosure to patients.