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

Sorensen, Ros, Iedema, Rick, Piper, Donella, Manias, Elizabeth, Williams, Allison and Tuckett, Anthony G. (2010) Disclosing clinical adverse events to patients: Can practice inform policy?. Health Expectations, 13 2: 148-159. doi:10.1111/j.1369-7625.2009.00569.x

Author Sorensen, Ros
Iedema, Rick
Piper, Donella
Manias, Elizabeth
Williams, Allison
Tuckett, Anthony G.
Title Disclosing clinical adverse events to patients: Can practice inform policy?
Journal name Health Expectations   Check publisher's open access policy
ISSN 1369-6513
Publication date 2010-06
Year available 2009
Sub-type Article (original research)
DOI 10.1111/j.1369-7625.2009.00569.x
Open Access Status DOI
Volume 13
Issue 2
Start page 148
End page 159
Total pages 12
Editor Vikki Entwistle
Place of publication United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2010
Language eng
Subject C1
160512 Social Policy
160508 Health Policy
920208 Health Policy Evaluation
Formatted 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.
Copyright © 1999–2011 John Wiley & Sons, Inc. All Rights Reserved.
Keyword Evaluation
Medical error
Open Disclosure
Patient involvement
Policy implementation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 5 OCT 2009

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Nursing, Midwifery and Social Work Publications
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Citation counts: TR Web of Science Citation Count  Cited 5 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 8 times in Scopus Article | Citations
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Created: Thu, 15 Oct 2009, 14:51:01 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work