Achieving closure through disclosure:

Matlow, Anne; Stevens, Polly; Harrison, Christine; Laxer, Ronald M.

doi:10.1016/j.jpeds.2004.01.013

Cited by 16 publications

(2 citation statements)

References 12 publications

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“…The 2008 Veterans Health Administration (VHA) directive, Disclosure of Adverse Events to Patients, 51 is one of the few policies which has been explicit about its stance on serious and minor errors and events, stating that even when a near miss occurs, disclosure of such 'close calls' is recommended if the patient may have become aware that something strange had occurred. 52,53 One account describes the useful role lay members can play in informing decisions with regard to disclosure. Even in well-motivated organisations which try to implement openness, it can be useful to have lay members as part of a review board to ensure decisions remain patient centred.…”

Section: Definitions Of Error or Harmmentioning

confidence: 99%

“…However, there are many variations in these laws between states. Some protect oral, but not written, statements; 46 some mandate that hospitals or their physicians notify patients of medical errors leading to adverse outcomes, moving beyond voluntary disclosure [52][53][54]57 with laws to protect the required disclosure from being used as evidence of fault in any legal action. Some have suggested that apology laws usually do not protect physicians who expressly admit fault or use explanations or statements that can be interpreted as admitting fault, and that in such cases physicians could find themselves in difficulty regarding explanations and disclosure of error.…”

Section: Apology Lawsmentioning

confidence: 99%

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An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration

Birks

Harrison

Bosanquet

et al. 2014

Health Services and Delivery Research

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BackgroundIn 2009 the UK National Patient Safety Agency relaunched its Being Open framework to facilitate the open disclosure of adverse events to patients in the NHS. The implementation of the framework has been, and remains, challenging in practice.AimThe aim of this work was to both critically evaluate and extend the current evidence base relating to open disclosure, with a view to supporting the implementation of a policy of open disclosure of adverse events in the NHS.MethodsThis work was conducted in three phases. The first phase comprised two focused systematic literature reviews, one summarising empirical research on the effectiveness of interventions to enhance open disclosure, and a second, broader scoping review, looking at reports of current opinion and practice and wider knowledge. The second phase involved primary qualitative research with the objective of generating new knowledge about UK-based stakeholders’ views on their role in and experiences of open disclosure. Stakeholder interviews were analysed using the framework approach. The third phase synthesised the findings from the first two phases to inform and develop a set of short pragmatic suggestions for NHS trust management, to facilitate the implementation and evaluation of open disclosure.ResultsA total of 610 papers met the inclusion criteria for the broad review. A large body of literature discussed open disclosure from a number of related, but sometimes conflicted, perspectives. Evidential gaps persist and current practice is based largely on expert consensus rather than evidence. There appears to be a tension between the existing pragmatic guidance and the more in-depth critiques of what being consistent and transparent in health care really means. Eleven papers met the inclusion criteria for the more focused review. There was little evidence for the effectiveness of disclosure alone on organisational or individual outcomes or of interventions to promote and support open disclosure. Interviews with stakeholders identified strong support for the basic principle of being honest with patients or relatives when someone was seriously harmed by health care. In practice however, the issues are complex and there is confusion about a number of issues relating to disclosure policies in the UK. The interviews generated insights into the difficulties perceived within health care at individual and institutional levels, in relation to fully implementing the Being Open guidance.ConclusionsThere are several clear strategies that the NHS could learn from to implement and sustain a policy of openness. Literature reviews and stakeholder accounts both identified the potential benefits of a culture that was generally more open (not just retrospectively open about serious harm). Future work could usefully evaluate the impact of disclosure on legal challenges within the NHS, best practice in models of support and training for open disclosure, embedding disclosure conversations in critical incident analysis and disclosure of less serious events.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Definitions Of Error or Harmmentioning

confidence: 99%

Section: Apology Lawsmentioning

confidence: 99%

An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration

Birks

Harrison

Bosanquet

et al. 2014

Health Services and Delivery Research

View full text Add to dashboard Cite

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Disclosing Harmful Medical Errors to Patients

Gallagher¹,

Levinson²

2005

Arch Intern Med

101

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Reporting and Disclosing Medical Errors

Garbutt¹,

Brownstein²,

Klein³

et al. 2007

Arch Pediatr Adolesc Med

121

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Objective: To characterize pediatricians' attitudes and experiences regarding communicating about errors with the hospital and patients' families.Design: Cross-sectional survey.Setting: St Louis, Mo, and Seattle, Wash.Participants: University-affiliated hospital and community pediatricians and pediatric residents. Results: Four hundred thirty-nine pediatric attending physicians and 118 residents participated (62% response rate). Most respondents had been involved in an error (39%, serious; 72%, minor; 61%, near miss; 7%, none). Respondents endorsed reporting errors to the hospital (97%, serious; 90%, minor; 82%, near miss), but only 39% thought that current error reporting systems were adequate. Most pediatricians had used a formal error reporting mechanism, such as an incident report (65%), but many also used informal reporting mechanisms, such as telling a supervisor (47%) or senior physician (38%), and discussed errors with colleagues (72%). Respondents endorsed disclosing errors to patients' families (99%, serious; 90%, minor; 39%, near miss), and many had done so (36%, serious; 52%, minor). Residents were more likely than attending physicians to believe that disclosing a serious error would be difficult (96% vs 86%; P=.004) and to want disclosure training (69% vs 56%; P =.03). Conclusions:Pediatricians are willing to report errors to hospitals and disclose errors to patients' families but believe current reporting systems are inadequate and struggle with error disclosure. Improving error reporting systems and encouraging physicians to report near misses, as well as providing training in error disclosure, could help prevent future errors and increase patient trust.

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Achieving closure through disclosure:

Cited by 16 publications

References 12 publications

An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration

An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration

Disclosing Harmful Medical Errors to Patients

Reporting and Disclosing Medical Errors

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