June-21-2013 in Healthcare Law

Open disclosure has been described by the Australian Commission on Safety and Quality in Healthcare as “an open discussion of incidents that result in harm to a Patient while receiving healthcare. This includes expressing regret for what has happened, keeping the Patient informed, providing feedback on investigations and the steps taken to manage the event and prevent and prevent a reoccurrence”.

In her article “An analysis of the culture in Ireland on open disclosure following adverse events in healthcare”, Ann Duffy, Clinical Risk Advisor, State Claims Agency assesses open disclosure in Ireland from the Patient’s and Healthcare Team’s perspective.

A questionnaire was disseminated to a multidisciplinary healthcare group at four multidisciplinary healthcare educational study days organised by the State Claims Agency. The response rate was 67%. A total of 56.5% of respondents stated that their organisation did not have an open disclosure policy, procedure or guideline in place, with 16% of the attendees stating that there was one.

Ms Duffy concludes that the vast majority of health organisations do not have a policy, procedure or guideline in place for open disclosure. Those that do, at times appear to be a clinician dependant decision and not a team based decision to disclose. However, there are areas of good practice occurring with many organisations holding multidisciplinary team meetings prior to meeting with the family. Disclosure of the incident can be complex, with over half the respondents indicating that there are barriers to disclosure, highlighting fear of litigation as a top concern, followed by blame, cultural and disciplinary concerns. All respondents were asked if they would be interested in attending a workshop in open disclosure and a majority of 89.1% advised they would like further information, awareness and debate surrounding open disclosure of adverse events.

The State Claims Agency (Clinical Indemnity Scheme) is currently piloting open disclosure, two major acute settings in Cork University Hospital and the Mater Hospital in Ireland.

(We would like to thank Ms Ann Duffy, Clinical Risk Advisor, State Claims Agency for her kind permission to reference her article.)

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