Open Disclosure information for staff
Effective patient incident management and open disclosure processes are attributes of high-quality health service organisations, and important parts of quality improvement and consumer- or patient-centred approach to healthcare.
Open disclosure is the process of providing an open, consistent approach to communicating with patients/consumers, their family, carer and/or support person (consumers) following an incident. This process includes expressing regret or saying sorry.
Consumers should be supported, cared for and provided with information in every step of the open disclosure process.
- Consumers can contribute to the investigation, and may make suggestions during open disclosure which contribute to improving the safety and quality of care.
- it is important that consumers are informed of the recommendations arising and actions taken or planned to prevent recurrence and improve safety and quality of the service
Doing these things can assist affected consumers to recover from the incident and restore their confidence in their health care.
The Patient Incident Management and Open Disclosure Policy Directive (PDF 1.9MB) describes a standardised system for managing patient incidents and open disclosure processes. This includes regular review of the open disclosure processes, and patient experience of incidents.
Education and training
It is expected that all staff will complete the online eLearning course on Patient Incident Management and open disclosure (available on the SA Health intranet Safety and Quality website) and use the resources in the open disclosure toolkit to guide the conduct of, and participation in, open disclosure.
There are 2 levels of Open Disclosure process.
- Incidents that are rated SAC 1 or SAC 2 require a Level 1 process. This includes the participation of a senior member of the clinical team, and also a staff member who has undergone Open Disclosure Facilitator training. For further information about this training contact local Safety and Quality Manager.
- Level 2 is for SAC 3 and SAC 4 rated incidents.
Open Disclosure Toolkit
The policy directive has a toolkit that has been developed to assist staff to conduct, or participate in an open disclosure process for level 1 (SAC 1 and 2) and level 2 (SAC 3 and 4) incidents.
Consumer information and resources are available on the Open disclosure information for consumers page.
- Guide on how to use the Patient Incident Management and Open Disclosure toolkit (PDF 108KB)
- Map of documents and tools for patient Incident Management and Open Disclosure (PDF 61KB)
This is a quick guide which provides information on the level 1 (SAC 1 and 2) and level 2 (SAC 3 and 4) responses to open disclosure and the process.
This is a guide which provides staff with information and examples on appropriate wording and phrasing for the open disclosure process, as an expression of regret.
This is a comprehensive guide for clinical leads / facilitators with more detailed information on the formal open disclosure process, and tools.
This is a patient / consumer information brochure on the open disclosure process.It outlines what is open disclosure, when should open disclosure occur, what the benefit of open disclosure is, and where to obtain additional information.
The booklet – a guide for patients/consumers beginning an open disclosure process is designed to help patients, consumers, families, carers and/or support person when an incident resulting in harm has occurred.The guide talks about health services (including hospitals), outlines what an incident is, what the open disclosure process is, what they can expect from the process, including how to prepare for the first open disclosure meeting.
Tool 6 - Open disclosure flowchart for patients/consumers – incident resulting in harm and near miss / no harm (PDF 65KB)
This flowchart illustrates the steps in the reporting and management of an incident resulting in harm, and a near miss incident for patient/consumers, their families, carers and/or support persons.
Tool 7 – Frequently asked questions about Open Disclosure for patients/consumers, families, carers and/or support persons. (PDF 63KB)
This information sheets provides patients/consumers, their families, carers and/or support persons with frequently asked questions about the open disclosure process, including what is open disclosure, what to expect in the process, what is an incident, what you can do, and how to find out more information on open disclosure.
This topic guide will assist managers and Open disclosure facilitators to record in Safety Learning System (SLS) the Level 1 or 2 Open disclosure process that occurs in response to a patient incident.
This checklist is a tool to assist staff in the open disclosure process.It outlines key activities to be completed as part of the open disclosure process.
The tool provides staff with information on what to consider when communicating with patients, including the patient needs for children, mental health conditions, culturally and linguistically diverse, aboriginal and torres strait islander, hearing or vision impaired, people with a disability; cognitive impairment.Information on the importance of communicating early, advocacy and support requirements, reimbursement, and ongoing care, and other considerations.It also outlines the patient/consumer resources available, refers to the saying sorry guide, and patient evaluation process of the open disclosure process.
The tool provides staff with information on key considerations such as providing advice and training on incidents, communication skills, and the need for support. It outlines the staff rights and responsibilities, use of substitute clinicians, and assistance with initial open disclosure discussions.It also provides staff with information on legal counsel, what junior clinicians can benefit in observing and participating in open disclosure.
This checklist is a tool to assist staff in the open disclosure process for beginning the meeting, what to do during the meeting ie explaining the facts, identifying patient's key concerns and expressing regret. It also provides information on closing the discussion and subsequent follow up.
This meeting planning and preparation tool is designed to assist in planning for the first open disclosure meeting, and provides a guide on the information to source for the meeting.
The open disclosure documentation and discussion summary is to be completed with the patient/consumer, their family, carer and/or support person.The summary provides a brief factual summary of incident, staff member who led the open disclosure discussions, summary of all points explained and plans for follow up.
The patient/consumer, family, carer and/or support person evaluation survey has been developed to enable feedback from patients/consumers, their families, their carers and/or support person about the open disclosure process. The aim of the survey is to improve the open disclosure experience for people involved in an incident that resulted in harm to a patient while receiving health care.
The staff evaluation survey has been developed to enable feedback from staff about the open disclosure process. The aim of this survey is to improve the open disclosure experience for people involved in an incident that resulted in harm to a patient while receiving health care.
This flowchart illustrates the steps in the reporting and management of an incident resulting in harm for level 1 (SAC 1 or SAC 2) open disclosure response.
This flowchart illustrates the steps in the reporting and management of a near miss for level 2 (SAC 3 or SAC 4) open disclosure response.
Safety Learning System (SLS) and Open Disclosure
Use SLS to record that Open Disclosure has occurred. The SLS Topic Guide Tool 8 – Safety Learning System (SLS) topic guide for open disclosure (PDF 90KB) assist managers and Open disclosure facilitators to record in Safety Learning System (SLS) the Level 1 or 2 Open disclosure process that occurs in response to a patient incident.
For more information on for reporting and managing patient incidents using the SLS see the Patient incident management in Safety Learning System page.
Safety and Quality Unit
Telephone: (08) 8226 6971