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Objective: To determine which aspects of open disclosure “work” for patients and health care staff, based on an evaluation of the National Open Disclosure Pilot. Design, setting and participants: Qualitative analysis of semi‐structured and open‐ended interviews conducted between March and October 2007 with 131 clinical staff and 23 patients and family members who had participated in one or more open disclosure meetings. 21 of 40 pilot hospital sites, in New South Wales, South Australia, Victoria and Queensland, were included in the evaluation. Participating health care staff comprised 49 doctors, 20 nurses, and 62 managerial and support staff. In‐depth qualitative data analysis involved mapping of discursive themes and subthemes across the interview transcripts. Results: Interviewees broadly supported open disclosure; they expressed uncertainty about its deployment and consequences, and made detailed suggestions of ways to optimise the experience, including careful pre‐planning, participation by senior medical staff, and attentiveness to consumers’ experience of the adverse event. Conclusion: Despite some uncertainties, the national evaluation indicates strong support for open disclosure from both health care staff and consumers, as well as a need to resource this new practice.

Aims and ObjectivesThis paper explores patients' perspectives on infection prevention and control.

In the last decade, the field of patient safety has grappled with the complexity of health-care systems by attending to the activity of frontline clinicians. This article extends the field by highlighting the activity of patients and their carers in determining the safety of these systems. We draw on data from three studies exploring patients' accounts of their health-care experiences in Australia and internationally, to show how patients and carers are currently contributing to the safety of their own care. Furthermore, we emphasise the importance of patient-clinician collaboration in ensuring the success of these activities. We argue that it is no longer sufficient to discuss if patients should be involved with ensuring their own safety. Given that patients are already involved, we propose a new conceptualisation of safety and systems that acknowledges their involvement and supports patient-provider collaboration to achieve safer care.

ObjectiveTo strengthen clinicians’ infection control awareness and risk realisation by engaging them in scrutinising footage of their own infection control practices and enabling them to articulate challenges and design improvements.Design and participantsClinicians and patients from selected wards of 2 hospitals in western Sydney.Main outcome measuresEvidence of risk realisation and new insights into infection control as articulated during video-reflexive feedback meetings.ResultsFrontline clinicians identified previously unrecognised infection risks in their own practices and in their team's practices. They also formulated safer ways of dealing with, for example, charts and patient transfers.ConclusionsVideo-reflexive ethnography enables frontline clinicians to identify infection risks and to design locally tailored solutions for existing risks and emerging ones.