SPIKES, open disclosure and death notification

SPIKES: a six-step protocol for disclosing unfavourable information — gather information, transmit the medical facts, support the patient, and elicit collaboration on the strategy or treatment plan.^[1] Skipping Perception is the classic fail — confirm Understanding against local communication teaching.

Death notification: irreversible news to family; use plain language; coronial/donation pathways and viewing per local bereavement protocol. Death-notification teaching is a core difficult conversation for emergency physicians.^[2]

^[2]Open disclosure: harm from care; apologise for harm/experience without inventing liability; facts; investigation plan; incident report; named follow-up — confirm wording against local open-disclosure policy.

Second victim: hot debrief now; cold debrief later; peer support; EAP — per local staff-support pathway.