Marie Prothero
Excerpts from Her Homecoming 2016 Address
“I believe that for us to move healthcare forward into achieving quality healthcare and outcomes, we must have transparency,” says Marie Mellor Prothero (MS ’96), MSN, RN, FACHE. [At the time of the lecture], Prothero is the executive director of quality for St. Mark’s Hospital in Salt Lake City. She oversees her organization’s quality assurance, including electronic reporting, patient concerns, and physician compliance. She also strives to improve process flow and safety efforts. Prothero is currently working on a Ph.D. in nursing from the University of Utah; her dissertation is focused on transparency in healthcare and the role of an apology following a medical error.
The attributes of an apology include expressing regret and sorrow, admitting fault with a statement that an error occurred, listening with dignity and respect, correcting the mistake and ensuring it will not happen again, and offering restitution to the victim.
Her studies highlight several antecedents, such as why we apologize and the corollaries of not apologizing when there is a medical mistake or accident. “We must realize [that the] consequences of not apologizing affect our emotional, spiritual, and physical well-being,” says Prothero. “And if left unresolved, [mistakes] can create feelings of bitterness and even increase litigation and settlement costs.”
To give an effective apology, one must express regret and sorrow; you cannot fully apologize without remorse. “A conversation casually informing a patient of the error is inadequate,” says Prothero, “and so is a statement that seems forced and insults others’ intelligence.” Appropriately apologizing takes the right setting and practice.
Prothero’s research serves as a starting point for additional inquiry to explore the nature and types of apologies. In addition, it will help other nurse leaders identify what comes after the apology and if the patient-provider relationship can be repaired. “There must be ongoing communication as additional details are learned—with the patient and family members, as well as with unit staff and hospital administrators,” she says. “Once we identify system changes, we must involve others to ensure needs are met, and proper training occurs.”
Further, Prothero’s studies clarify the role of nursing in disclosure, apology, and creating a culture of safety in which everyone feels valued and able to speak up. “We must continue the important work of quality assurance, process improvement, and system improvement,” she says. “Never forget that every patient matters.”
She also emphasizes that nurses have the opportunity to be leaders with a broad impact on their organization. “Leadership is interdisciplinary and [is] a team approach,” she says. “You must know your strengths and weaknesses and understand what you bring to the team. Then surround yourself with people different from you and learn from each other for success.”
Prothero has been a leader her whole career. Before St. Mark’s, she was the CEO of Utah Valley Specialty Hospital in Provo for seven years, the CEO of Ernest Health for four years, and an operations officer with Intermountain Healthcare for 22 years.
“Never stop learning and developing your nursing and leadership skills,” she concludes. “Success comes from ensuring the success of your peers. Take time to remove roadblocks, recognize achievement, and encourage others. You can see the best in your team by being a positive influence.”