What prevents incident disclosure, and what can be done to promote it?

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dc.contributor.author Iedema, R
dc.contributor.author Allen, S
dc.contributor.author Sorensen, R
dc.contributor.author Gallagher, TH
dc.date.accessioned 2012-10-12T03:35:38Z
dc.date.issued 2011-09
dc.identifier.citation Joint Commission journal on quality and patient safety / Joint Commission Resources, 2011, 37 (9), pp. 409 - 417
dc.identifier.issn 1553-7250
dc.identifier.other C1 en_US
dc.identifier.uri http://hdl.handle.net/10453/19049
dc.description.abstract BACKGROUND: Adverse-event incident disclosure is gaining international attention as being central to incident management, practice improvement, and public engagement, but those charged with its execution are experiencing barriers. Findings have emerged from two large studies: an evaluation of the 2006-2008 Australian Open Disclosure Pilot, and a 2009-2010 study of patients' and relatives' views on actual disclosures. Clinicians and patients interviewed in depth suggest that open disclosure communication has been prevented by a range of uncertainties, fears, and doubts. METHODS: Across Australia, 147 clinical staff were interviewed (mostly over the phone), and 142 patients and relatives were interviewed in their homes or over the phone. Interviews were recorded, transcribed, and analysed by three independent investigators. Transcription analyses yielded thematic domains, each with a range of ancillary issues. RESULTS: Analysis of interview transcripts revealed several important barriers to disclosure: uncertainty among clinicians about what patients and family members regard as requiring disclosure; clinicians' assumption that those harmed are intent on blaming individuals and not interested in or capable of understanding the full complexity of clinical failures; concerns on the part of clinicians about how to interact with (angry or distressed) patients and family members; uncertainties about how to guide colleagues through disclosure; and doubts surrounding how to manage disclosure in the context of suspected litigation risk, qualified-privilege constraints, and risk-averse approaches adopted by insurers. CONCLUSIONS: Disclosure practices appear to be inhibited by a wide range of barriers, only some of which have been previously reported. Strategies to overcome them are put forward for frontline clinicians, managerial staff, patient advocates, and policy agencies.
dc.format Print
dc.language eng
dc.title What prevents incident disclosure, and what can be done to promote it?
dc.type Journal Article
dc.parent Joint Commission journal on quality and patient safety / Joint Commission Resources
dc.journal.volume 9
dc.journal.volume 37
dc.journal.number 9 en_US
dc.publocation United States en_US
dc.identifier.startpage 409 en_US
dc.identifier.endpage 417 en_US
dc.cauo.name FOH.Faculty of Health en_US
dc.conference Verified OK en_US
dc.for 2001 Communication and Media Studies
dc.for 1117 Public Health and Health Services
dc.personcode 100638
dc.personcode 996762
dc.personcode 040083
dc.percentage 67 en_US
dc.classification.name Communication and Media Studies en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
dc.description.keywords NA en_US
dc.description.keywords NA
dc.description.keywords Humans
dc.description.keywords Professional-Family Relations
dc.description.keywords Professional-Patient Relations
dc.description.keywords Attitude of Health Personnel
dc.description.keywords Health Knowledge, Attitudes, Practice
dc.description.keywords Disclosure
dc.description.keywords Risk Management
dc.description.keywords Liability, Legal
dc.description.keywords Communication Barriers
dc.description.keywords Australia
dc.description.keywords Social Responsibility
dc.description.keywords Uncertainty
dc.description.keywords Humans
dc.description.keywords Professional-Family Relations
dc.description.keywords Professional-Patient Relations
dc.description.keywords Attitude of Health Personnel
dc.description.keywords Health Knowledge, Attitudes, Practice
dc.description.keywords Disclosure
dc.description.keywords Risk Management
dc.description.keywords Liability, Legal
dc.description.keywords Communication Barriers
dc.description.keywords Australia
dc.description.keywords Social Responsibility
dc.description.keywords Uncertainty
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Faculty of Arts and Social Sciences
pubs.organisational-group /University of Technology Sydney/Faculty of Arts and Social Sciences/Communication & Learning Group
pubs.organisational-group /University of Technology Sydney/Strength - Research in Learning and Change
utslib.copyright.status Closed Access
utslib.copyright.date 2015-04-15 12:17:09.805752+10


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