Open Disclosure is an open and consistent approach to communicating with patients and their families when things go wrong in healthcare. This includes expressing regret for what has happened, keeping the patient informed, providing feedback on investigations and the steps taken to prevent a recurrence of the adverse event. Open Disclosure is important for building patient and public trust in the health system.
The purposes of Open Disclosure overall are to:
· ensure that patients are informed when adverse events happen as soon as is practicable,
· assist in supporting appropriate patient care,
· increase trust between patients and their clinicians,
· support staff in managing adverse events, and
· improve patient safety and quality of care through organisational learning.
Open Disclosure can be viewed as an integral element of patient safety incident management and it is government policy that a system of open disclosure is in place and supported across the health system.
The HSE Open Disclosure Policy and Medical Practitioners Guide to Professional Conduct and Ethics sets out clear requirements for open disclosure.
Patient Safety Bill
The Government approved on 5th July 2018, the general scheme of the Patient Safety Bill. This Bill provides for mandatory open disclosure, mandatory external notification of patient safety incidents, clinical audit guidance and the extension of remit of HIQA to private hospitals.
The Patient Safety Bill will now be referred to the Health Committee.
Minister Harris announces Government approval for the Patient Safety Bill
Civil Liability (Amendment) Act, 2017, Part 4 Open Disclosure
The Civil Liability (Amendment) Act, 2017, provides the legal framework to support voluntary open disclosure. The Act applies to all patient safety incidents including near misses and no-harm events. It provides for an open and consistent approach to communicating with patients and their families and providing an apology, as appropriate, when things go wrong in healthcare.
The provisions are designed to give legal protection for the information and apology made to a patient during open disclosure when made in line with the legislation. The apology cannot be used in litigation against the provider. The approach is intended to create a positive voluntary climate for open disclosure.
The Minister signed the commencement order on 3rd July 2018 for this legislation and signed the regulations to accompany the Act on 4th July 2018. There will come into effect on 23rd September 2018.
The provisions are an enhancement of one part of the open disclosure procedure and are in addition to the current open disclosure policies and procedures in place with the health service. The next step will be mandatory open disclosure which forms of the Patient Safety Bill as outlined above.
Listen to the Jct Committee on Health – Pre-Legislative Scrutiny on the Open Disclosure Provisions contained in the Civil Liability (Amendment) Bill
Report on the Pre-Legislative Scrutiny on the ‘Open Disclosure’ provisions, to be included in the Civil Liability (Amendment) Bill – February 2017
CMO Opening Statement on Open Disclosure to the Joint Committee on Health – 13 Oct 2016
Information Note on Open Disclosure to the Joint Committee on Health – 28 July 2016
HSE National Policy on Open Disclosure
Civil Liability (Amendment) Act 2017