Open disclosure of adverse events: exploring the implications of service and policy structures on practice

Figures & data

Table

• Acknowledgement of a patient safety incident to the patient and/or their support person(s), as soon as possible, generally within 24 hours of the incident...

• Truthful, clear, and timely communication on an ongoing basis as required.

• Providing an apology to the patient and/or their support person(s) as early as possible, including the words “I am sorry” or “we are sorry”.

• Providing care and support to patients and/or their support person(s) which is responsive to their needs and expectations, for as long as is required.

• Providing support to those providing health care which is responsive to their needs and expectations.

• An integrated approach to improving patient safety, in which open disclosure is linked with clinical and corporate governance, incident reporting, risk management, complaints management, and quality improvement policies and processes…

• Multidisciplinary involvement…

• Compliance with legal requirements for privacy and confidentiality…

Notes: Data from Finlay et al.⁹

Table 1 Responder roles and organization (C: hospital based; P: policy or legal organization)

Respondent role/organization	Identifier
Nurse manager	C1
Medical defense	P1
Medical defense	P2
Clinical governance officer	C2
Patient safety officer	C3
Clinical governance director	C4
Government legal advisor	P3
Government policy advisor	P4
Patient safety officer	C5
Director of nursing	C6
Clinical governance director	C7
Clinical governance director	C8

Table

“Open disclosure is:

• a patient and consumer right;

• a core professional requirement and institutional obligation;

• a normal part of an episode of care should the unexpected occur, and a critical element of clinical communications;

• an attribute of high-quality health service organizations and important part of health care quality improvement”.

Notes: Data from McDonnell and Guenther.⁸

FinlayAStewartCParkerMOpen disclosure: ethical, professional and legal obligations and the way forward for regulationMed J Aust2013198844544823641998

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McDonnellWMGuentherENarrative review: do state laws make it easier to say “I’m sorry?”Ann Intern Med20081491181181519047028

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