Open Disclosure Process
Open disclosure is defined in the Australian Open Disclosure Framework2 as:
An open disclosure discussion is required whenever a patient has been involved in a patient safety incident.
Essential elements of effective open disclosure include:
- Apologising to the patient and/or their support person(s), including the words "I am sorry" or "we are sorry"
- Acknowledging the patient safety incident and the impact on the patient and/or their support person(s)
- Listening to and responding to the patient's experience, and/or that of their support person(s)
- Discussing the potential consequences of the incident
- Providing an opportunity for the patient and/or their support person(s) to ask questions and to have those questions answered
- Explaining the steps being taken to manage the incident and prevent recurrence
- Providing support for patients and/or their support person(s), and health care staff involved, to manage the physical and psychological consequences of what happened.
Open disclosure begins with a clinician disclosure discussion with the patient and/or their support person, within 24 hours of the patient safety incident. The purpose of clinician disclosure is to inform and support the patient and/or their support person(s) and to offer an apology for what has happened.
Checklist A Clinician Disclosure identifies the steps to be completed for the initial clinician disclosure discussion with a patient and/or his or her support person(s).
The STARS® Tool provides a framework for clinician disclosure discussion.
STARS® is a registered trademark of the State of Queensland (Queensland Health) (No. 1272399)
Formal Open Disclosure
Formal open disclosure is a structured process which follows on from clinician disclosure as soon as is practicable. It provides a format that facilitates effective and timely communication between the patient and/or their support person, clinicians, senior clinical leaders and the organisation.
Formal open disclosure may be required for any patient safety incident, as determined by the patient and/or their support person, the director of clinical governance (DCG) and/or the appropriate senior manager (for example the facility, operations or health service manager).
The following checklists may be useful for the different stages of Formal Open Disclosure.
- Checklist B Preparation For Formal Open Disclosure ~164KB
- Checklist C Open Disclosure Team Meeting ~165KB
- Checklist D During The Disclosure ~172KB
- Checklist E Completing Formal Open Disclosure ~171KB
The approach to open disclosure can vary depending on the particular circumstances of the incident. Each situation should be addressed on a case-by-case basis, and advice sought, if required, from an open disclosure advisor, or a senior colleague with experience in open disclosure.