Disclosing adverse events to patients: International norms and trends

Wu, AW; McCay, L; Levinson, W; Iedema, R; Wallace, G; Boyle, DJ; McDonald, TB; Bismark, MM; Kraman, SS; Forbes, E; Conway, JB; Gallagher, TH

Disclosing adverse events to patients: International norms and trends

Wu, AW McCay, L Levinson, W Iedema, R

Wallace, G Boyle, DJ McDonald, TB Bismark, MM Kraman, SS Forbes, E Conway, JB Gallagher, TH

Permalink

Publication Type:: Journal Article
Citation:: Journal of Patient Safety, 2017, 13 (1), pp. 43 - 49
Issue Date:: 2017-01-01

Closed Access

	Filename	Description	Size
	01209203-201703000-00008.pdf	Published Version	163.11 kB	Adobe PDF	View/Open

Copyright Clearance Process

Recently Added
In Progress
Closed Access

This item is closed access and not available.

Full metadata record

Field	Value	Language
dc.contributor.author	Wu, AW	en_US
dc.contributor.author	McCay, L	en_US
dc.contributor.author	Levinson, W	en_US
dc.contributor.author	Iedema, R https://orcid.org/0000-0001-6792-1048	en_US
dc.contributor.author	Wallace, G	en_US
dc.contributor.author	Boyle, DJ	en_US
dc.contributor.author	McDonald, TB	en_US
dc.contributor.author	Bismark, MM	en_US
dc.contributor.author	Kraman, SS	en_US
dc.contributor.author	Forbes, E	en_US
dc.contributor.author	Conway, JB	en_US
dc.contributor.author	Gallagher, TH	en_US
dc.date.issued	2017-01-01	en_US
dc.identifier.citation	Journal of Patient Safety, 2017, 13 (1), pp. 43 - 49	en_US
dc.identifier.issn	1549-8417	en_US
dc.identifier.uri	http://hdl.handle.net/10453/126941
dc.description.abstract	© Copyright 2017 Wolters Kluwer Health, Inc. Objectives: There is a growing expectation in health systems around the world that patients will be fully informed when adverse events occur. However, current disclosure practices often fall short of this expectation. Methods: We reviewed trends in policy and practice in 5 countries with extensive experience with adverse event disclosure: the United States, the United Kingdom, Canada, New Zealand, and Australia. Results: We identified 5 themes that reflect key challenges to disclosure: (1) the challenge of putting policy into large-scale practice, (2) the conflict between patient safety theory and patient expectations, (3) the conflict between legal privilege for quality improvement and open disclosure, (4) the challenge of aligning open disclosure with liability compensation, and (5) the challenge of measurement related to disclosure. Conclusions: Potential solutions include health worker education coupled with incentives to embed policy into practice, better communication about approaches beyond the punitive, legislation that allows both disclosure to patients and quality improvement protection for institutions, apology protection for providers, comprehensive disclosure programs that include patient compensation, delinking of patient compensation from regulatory scrutiny of disclosing physicians, legal and contractual requirements for disclosure, and better measurement of its occurrence and quality. A longerterm solution involves educating the public and health care workers about patient safety.	en_US
dc.relation.ispartof	Journal of Patient Safety	en_US
dc.relation.isbasedon	10.1097/PTS.0000000000000107	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Communication	en_US
dc.subject.mesh	Disclosure	en_US
dc.subject.mesh	Medical Errors	en_US
dc.subject.mesh	Canada	en_US
dc.subject.mesh	United States	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	New Zealand	en_US
dc.subject.mesh	Policy	en_US
dc.subject.mesh	Patient Safety	en_US
dc.subject.mesh	United Kingdom	en_US
dc.title	Disclosing adverse events to patients: International norms and trends	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	13	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Arts and Social Sciences
utslib.copyright.status	closed_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	13	en_US

Abstract:

© Copyright 2017 Wolters Kluwer Health, Inc. Objectives: There is a growing expectation in health systems around the world that patients will be fully informed when adverse events occur. However, current disclosure practices often fall short of this expectation. Methods: We reviewed trends in policy and practice in 5 countries with extensive experience with adverse event disclosure: the United States, the United Kingdom, Canada, New Zealand, and Australia. Results: We identified 5 themes that reflect key challenges to disclosure: (1) the challenge of putting policy into large-scale practice, (2) the conflict between patient safety theory and patient expectations, (3) the conflict between legal privilege for quality improvement and open disclosure, (4) the challenge of aligning open disclosure with liability compensation, and (5) the challenge of measurement related to disclosure. Conclusions: Potential solutions include health worker education coupled with incentives to embed policy into practice, better communication about approaches beyond the punitive, legislation that allows both disclosure to patients and quality improvement protection for institutions, apology protection for providers, comprehensive disclosure programs that include patient compensation, delinking of patient compensation from regulatory scrutiny of disclosing physicians, legal and contractual requirements for disclosure, and better measurement of its occurrence and quality. A longerterm solution involves educating the public and health care workers about patient safety.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/126941