Open Disclosure

Definitions

Apology: an expression of sorrow, sympathy and (where applicable) remorse by an individual, group or organisation for a harm or grievance. It should include the words “I am sorry” or “we are sorry”. Apology may also include an acknowledgement of responsibility which is not an admission of liability.

Adverse Event: an incident in which harm resulted to a person receiving healthcare.
 

Complaint: an expression of dissatisfaction or concern about any aspect of care provided by Mildura Health Private Hospital (MHPH)  Complaints may be lodged by the patient directly or, with the patient’s consent, by an interested party such as a relative, carer, or general practitioner. Complaints may be submitted verbally, in writing, electronically, or through patient feedback channels.
 

Open Disclosure: a transparent discussion with a patient about an incident(s) that resulted in harm during the provision of health care. The key elements of open disclosure include:
 

• An expression of regret, which must include the word "sorry"

• A factual account of what occurred

• An opportunity for the patient to share their experience

• An explanation of the steps being taken to manage the incident and prevent its recurrence.

 

Principles of Open Disclosure

(Based on ACSQHC National Open Disclosure Framework)

 

Open and Timely Communication

Patients, families, and carers must be provided with honest, transparent, and timely information about what occurred.

 

Acknowledgement

All adverse events must be acknowledged to the patient, their family, and carers as soon as practicable.

 

Apology or Expression of Regret

As early as possible, an apology or expression of regret should be offered to the patient, their family, and carers for any harm caused. This can be delivered verbally, in writing, or both.

 

Supporting Patients, Families, and Carers

Patients, their families, and carers should be fully informed, treated with empathy and respect, and supported according to their individual needs. They will also be actively involved in decision-making regarding their ongoing care following an adverse event.

 

Supporting Healthcare Providers

Health service organisations must cultivate a culture where staff feel empowered to report adverse events and are adequately trained and supported throughout the open disclosure process. Healthcare providers involved in adverse events will have access to support services, such as counselling, debriefing sessions, and peer support programs, to address the emotional and psychological impact of the event.

 

Cultural Sensitivity

The open disclosure process will be conducted in a culturally sensitive manner, ensuring that communication and support are tailored to meet the cultural, linguistic, and religious needs of the patient and their family.

 

Integrated Clinical Risk Management and System Improvement

Insights gained from open disclosure should contribute to ongoing quality improvement and risk management initiatives.

 

Good Governance

Effective open disclosure requires strong governance, clear accountability, and integration with clinical risk management and quality improvement processes.

 

Confidentiality

Patient and clinician privacy must be respected throughout the open disclosure process, in compliance with relevant state, territory, and federal privacy laws.

 

Scope

This Policy applies to all incidents/adverse events occurring in the MHPH or Mildura Health Private Consulting.
 

Open Disclosure Process

• The Director of Clinical Services (DCS) and Chief Executive Officer (CEO), or their delegate(s), are responsible for conducting open disclosure with patients and their families.

• When preparing for open disclosure, the DCS and CEO should consult with senior clinicians and Visiting Medical Officers (VMOs) involved in the patient’s care to ensure all relevant stakeholders are informed.

• Apologies and expressions of regret are integral to open disclosure and may be offered without implying liability. Care should be taken to avoid speculation on the cause of the incident or premature conclusions before investigations are complete. It is also critical to avoid assigning blame during discussions.

• Patient and family involvement:
  Patients and their families will be invited to participate in discussions about the management of their ongoing care and any further treatment decisions following an adverse event.

• Follow-up communication:

 

The DCS or CEO will schedule follow-up communication with the patient and their family to provide updates on the investigation and any steps taken to prevent recurrence. Ongoing support will be offered where necessary.

• The privacy of both patients and staff must be upheld throughout the process.

• Legal counsel may be consulted or engaged if necessary, during the open disclosure process.

• All incidents and complaints must be recorded in RiskMan, following the hospital’s incident management protocols.

 

Documentation Requirements

• All communications and actions undertaken during the open disclosure process, including meetings, phone calls, and written correspondence, must be clearly documented. This ensures transparency and allows for future reference, if needed.

• A separate file should be maintained to document all communications and correspondence related to the open disclosure. Care should be taken to ensure that only factual information is communicated. This file must be kept separate from the patient’s medical records and the RiskMan system.

• The open disclosure process should follow relevant tools, templates, and documents, as outlined in hospital policy.

 

Escalation

If the patient or their family is dissatisfied with the outcome of the open disclosure process, they may escalate the matter for review by senior management or external mediation.

 

Training and Competency

All staff members involved in patient care will undergo mandatory training on the principles and procedures of open disclosure. This ensures that staff are confident and well prepared to communicate effectively, compassionately, and in alignment with MHPH policies.