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safety. Members of the communication consult service can be drawn from throughout the hospital. Chiefs of service, nurse managers, patient safety officers, risk managers, and members of bioethics committees are obvious candidates, but other individuals may have interest in and aptitude for the task. Research suggests that successful mediators are individuals who are perceived to be natural problem solvers and conflict resolvers within the institution and who exhibit the skills needed during disclosure conversations, regardless of title or status (Kressel et al. 2002). Even when time is limited, taking a few minutes to speak with a communication expert will improve the disclosure conversation. Planning a disclosure conversation in the aftermath of a medical error or adverse event is often thought of by health care professionals as an unachievable luxury. However, even when time is limited, taking a few minutes to speak with a communication expert about the following considerations will improve the disclosure conversation: Having the person with the best available information at the disclosure conversation is important for three reasons. First, patients expect to hear from the physician most involved and may become suspicious should that person not attend the meeting. Second, having the person with the best information present avoids having others succumb to the temptation to fill in the information blanks by speculating about what happened. Finally, receiving information and explanations can change the way those involved in the event view each others’ motives. If, for some reason, the physician most involved in the adverse event or error is unable to participate in the disclosure conversation, it is essential that the reason for non-attendance be made clear. In most cases an opportunity for a future conversation with that physician should be offered. Even though it is difficult for a professional to admit that he or she does not have answers to significant questions, speculation often proves wrong. The subsequent provision of correct information that is inconsistent with the initial speculation may be seen as “changing the story” or “covering up.” When patients and their family members receive information about what happened and why, they may react to an error or adverse event with less anger and blame. Attribution theory research examines both how people interpret the causes of observed behavior and the implications of attribution for their emotions and reactions (Allred 2000). Most people tend to attribute another person’s negative behavior to innate disposition or character while attributing their own behavior to circumstances. The person who is harmed assigns the negative behavior to causes under the control of the other and responds with anger. At the same time, the person who has caused injury attributes his or her own behavior to circumstances beyond his or her control. The resulting difference “in judgment of the harm doer’s responsibility … can lead to the most destructive kinds of anger-driven-conflict” (ibid.). Given attribution theory research, it seems important during disclosure conversations to provide all of the available information known at that moment. If further studies support these findings, and we anticipate that they will, physicians and hospitals will need to think carefully about the words they use when disclosing an error and apologizing. Situations in which a mistake has been made but the health care provider was not negligent, or in which the patient suffers from an adverse event after being warned that the event might occur, provide special challenges. For example, what is the appropriate response when a mistake has been made but the physician was not negligent? When a surgeon nicks the bowel during surgery, a mistake has been made but the physician’s conduct may have been well within acceptable standards of care. What is the best response when the appropriate treatment is selected and provided correctly but the patient is among that group for whom the consequence of the treatment is harm? The physician may feel he or she has nothing to apologize for since the patient and family were warned of the risks of the treatment. But the patient may have failed to hear (or have been emotionally unable to hear) the warnings and instead may believe that