Open Disclosure

Open disclosure is an open discussion with a patient who has received harm during medical care. The open disclosure process is a:

• Patient right
• Professional and institutional obligation
• Part of healthcare quality improvement
• Long and complex process involving both:
  • Conversation
    Often multiple conversations over a period of time.
  • Administrative actions
    An investigation and report, which may take a long time.

Open Disclosure Conversation

The open disclosure conversation includes:

0. Signpost the purpose of the meeting
   “I’m here to tell you about a medical error that has been made.”
1. A factual explanation of what happened
2. An apology
   Including the words “I am sorry”, and an admission of responsibility. This is distinct from an admission of liability.
3. Responding to questions
4. Setting a time for follow-up
   Should include:
   • Answering further questions
   • An explanation of steps to prevent recurrence

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References

1. CICM Communications Course. Course Notes. 2023.