Consultation on the Review of the Open Disclosure Standard
Australian Commission on Safety and Quality in Healthcare
The national Open Disclosure Standard was first released by the former Australian Council for Safety and Quality in Health Care and endorsed by Australian Health Ministers in 2003. It was the first national policy document of its kind in the world. The Commission is currently undertaking a review of the Standard. Following the consultation process materials and resources to support uptake and facilitate implementation will then be developed to complement the revised Standard.
The review of the National Open Disclosure Standard and the introduction of the National Safety and Quality Health Service Standards present an opportunity to further develop the positive practice of open disclosure in Australian health care services.
HCA has previously worked with health consumers and SA Health in the development of local policy, guidelines and resources on open disclosure in South Australia and this work can be viewed below.
We do know of some practice improvement in some health services, but as the 100 Patient Stories Project identified, there is still much opportunity for improvement in Australia in the practice of open disclosure. The push for appropriate and effective disclosure is yet to translate into systemic improvement in outcomes for consumers, families and carers in Australia.
HCA's submission to the Commission is available here.
“Being Open is the practice of open discussion and action following medical errors that occurred to a consumer as a result of receiving care in any health care setting”.
There is significant evidence about patient harm caused by alarmingly high rates of medical errors across Australia. This can result in outcomes ranging from death, to loss of capacity, to mistakes with medications through to infection caused by the poor hygiene practices of some health professionals.
Consumers are justifiably asking “What is to be done?” One clear response is to assist those affected by such an error and then to ask the hard questions “How did this happen? What can be done to help prevent it happening again?”
Health professionals refer to the policy of responding to consumers and families affected by a health care error as open disclosure. Open Disclosure is the discussions that health professionals and hospital staff have with patients and their families who have experienced harm while receiving health care.
Health services may be tempted to see Open Disclosure as part of a risk management strategy. Consumer advocates understandably see the need to responses to errors from a moral and human rights perspective. Health rights always need be at the forefront of action and practices in health care when things go wrong. Adherence to these rights would give meaningful effect to a consumers’ right to safe, quality health care delivered by services and professionals who routinely treat them with dignity and respect. Upholding the right to openness and effective action in the face of an error is therefore not about a way to limit litigation but is fundamentally it the right thing to do, especially when harm occurs.
SA Health established an Open Disclosure Advisory Group in November 2009. The purpose of the Advisory Group was to:
- Identify strategic policy directions & priorities for service development and delivery
- Promote an environment that encourages open communication with consumers who have experienced an incident during their contact with SA Health
- Promote a culture of shared learning and improved practice appropriate and effective open disclosure
During 2010 and 2011, HCA worked in partnership with health consumers and SA Health's Safety and Quality Unit to develop an Open Disclosure Policy and Guidelines. Two HCA Members Policy Forums were held in December 2010 and February 2011 to seek consumer views on the draft policy and guidelines. HCA provided feedback to SA Health based on the comments and suggestions of our members (cover letter and submission).
In 2010, HCA published a position paper to guide the implementation and development of Open Disclosure Policy and Guidelines in South Australia. SA Health released the final Open Disclosure Policy and Guidelines which apply to all SA Health Services in October 2011. SA Health have also produced a lanyard, postcard and checklist.
The work of the Advisory Group was very much guided by the Standard published in 2008 by the Australian Commission on Safety and Quality in Healthcare. The Commission is currently conducting a review of the national Open Disclosure Standard (the Standard).
The consultation is based on the proposed revised Standard:
Background material to revised standard:
The Commission is seeking responses to the questions below and any additional comments by 31 August 2012.
- Is current evidence reflected in the Australian Open Disclosure Framework – Consultation Draft?
- Are there any aspects of open disclosure that need further exploration?
- Is the working title Australian Open Disclosure Framework suitable? If not, what would be a more appropriate title?
- Is the terminology used throughout the Australian Open Disclosure Framework – Consultation Draft appropriate?
- Are the essential steps for open disclosure reflected in the Australian Open Disclosure Framework – Consultation Draft?
- Will the Australian Open Disclosure Framework – Consultation Draft assist health services to implement best practice open disclosure?
- Are there any elements missing from the Australian Open Disclosure Framework – Consultation Draft?
- What types of resources and materials should there be to assist in implementation of the Australian Open Disclosure Framework – Consultation Draft?
- Are the proposed outcome and process measures appropriate? If not, what do you suggest as more relevant measures?
- Are there any additional comments?
HCA is committed to working with a range of stakeholders to achieve awareness and implementation of open disclosure across the state and ensure that the voice of consumers and their families are heard and acknowledged.