institutional response should provide attention to
the victims of this event, while a parallel analysis
or investigation takes place. Continuous feedback
between these actions is also necessary to achieve
better solutions. 4 When we consider the word
‘victim’ in this scenario, we are referring not only
to the patient involved in the event, but also to
the family members with whom we will be
dealing from this point on; all of them may be
referred to as ‘primary victims’. However, all of
the healthcare providers involved and
traumatised by the event should be also
considered as victims (‘secondary victim’ in this
case) and thereby receive fair and appropriate
attention.
Dealing with the ‘primary victims’ (usually
family members expecting to be informed) should
occur promptly, in a proper and comfortable
atmosphere and ideally during the first 60
minutes of the event. The professionals
conducting this initial interview must be chosen
carefully (excluding those directly involved in
the event if not prepared or suitable at that
moment) and be aware that they should provide
details of the exact causes of the adverse event.
All the details of this first approach must be
registered in the patient’s file or clinical history.
As for the information provided, it must be as
clear as possible, and allow opportunities for
the primary victims to ask questions and confirm
that they have understood all the information
given.
Regarding the topics of “what to inform?”
and “how to do it?”, the professionals in charge
are responsible to, above all, be honest, give
information based only on known facts, and
commit to the analysis of the event and provide
conclusive results once they are available.
Empathy and apologies should be accompanied
by offers of help for additional needs, and directly
blaming professionals not present at the time or
the system itself should be avoided. It is
important to mention that despite following
these guidelines, and adequate preparation for
this initial interview, primary victims might not
receive this information well and act defensively,
or even focus on determining guilt or seeking
financial compensation. If the later happens, legal
counsel and means to facilitate this should be
provided.
Secondary victims should