• Open Access

Disclosing clinical adverse events to patients: can practice inform policy?

Authors


Ros Sorensen PhD
Senior Lecturer
Faculty Nursing, Midwifery & Health
University of Technology
PO Box 123
Broadway, Sydney
New South Wales 2007
E-mail: Roslyn.sorensen@uts.edu.au

Abstract

Objectives  To understand patients’ and health professionals’ experience of Open Disclosure and how practice can inform policy.

Background  Open Disclosure procedures are being implemented in health services worldwide yet empirical evidence on which to base models of patient–clinician communication and policy development is scant.

Design, setting and participants  A qualitative method was employed using semi-structured open-ended interviews with 154 respondents (20 nursing, 49 medical, 59 clinical/administrative managerial, 3 policy coordinators, 15 patients and 8 family members) in 21 hospitals and health services in four Australian states.

Results  Both patients and health professionals were positive about Open Disclosure, although each differed in their assessments of practice effectiveness. We found that five major elements influenced patients’ and professionals’ experience of openly disclosing adverse events namely: initiating the disclosure, apologizing for the adverse event, taking the patient’s perspective, communicating the adverse event and being culturally aware.

Conclusions  Evaluating the impact of Open Disclosure refines policy implementation because it provides an evidence base to inform policy. Health services can use specific properties relating to each of the five Open Disclosure elements identified in this study as training standards and to assess the progress of policy implementation. However, health services must surmount their sensitivity to revealing the extent of error so that research into patient experiences can inform practice and policy development.

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