Open Disclosure Process

What is Open Disclosure?

Open disclosure is defined in the Australian Open Disclosure Framework¹ as:

An open disclosure discussion is required whenever a patient has been involved in a patient safety incident.

• Open Disclosure Handbook Chapter 2 - What is a patient safety incident? ~297KB

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 Handbook Chapter 3 - What is Open Disclosure ~474KB
Flow Chart of the Open Disclosure Process ~228KB

Clinician Disclosure

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.

• Open Disclosure Handbook Chapter 4 - Clinician Disclosure ~363KB

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).

• Checklist A Clinician Disclosure ~147KB

The STARS^® Tool provides a framework for clinician disclosure discussion.

• STARS^® Tool for Clinician Disclosure ~147KB

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).

• Open Disclosure Handbook Chapter 5 - Formal Open Disclosure ~321KB

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

Specific circumstances

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.

• Open Disclosure Handbook Chapter 9 - Open Disclosure in Specific Circumstances ~247KB