Patients' and family members' experiences of open disclosure following adverse events

Int J Qual Health Care. 2008 Dec;20(6):421-32. doi: 10.1093/intqhc/mzn043. Epub 2008 Sep 17.


Objective: To explore patients' and family members' perceptions of Open Disclosure of adverse events that occurred during their health care.

Design: We interviewed 23 people involved in adverse events and incident disclosure using a semi-structured, open-ended guide. We analyzed transcripts using thematic discourse analysis.

Setting: Four States in Australia: New South Wales, Victoria, Queensland and South Australia.

Study participants: Twenty-three participants were recruited as part of an evaluation of the Australian Open Disclosure pilot commissioned by the Australian Commission on Safety and Quality in Health Care.

Results: All participants (except one) appreciated the opportunity to meet with staff and have the adverse event explained to them. Their accounts also reveal a number of concerns about how Open Disclosure is enacted: disclosure not occurring promptly or too informally; disclosure not being adequately followed up with tangible support or change in practice; staff not offering an apology, and disclosure not providing opportunities for consumers to meet with the staff originally involved in the adverse event.

Analysis: of participants' accounts suggests that a combination of formal Open Disclosure, a full apology, and an offer of tangible support has a higher chance of gaining consumer satisfaction than if one or more of these components is absent.

Conclusions: Staff need to become more attuned in their disclosure communication to the victim s perceptions and experience of adverse events, to offer an appropriate apology, to support victims long-term as well as short-term, and to consider using consumers' insights into adverse events for the purpose of service improvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Health
  • Australia
  • Female
  • Humans
  • Male
  • Medical Errors*
  • Middle Aged
  • Pilot Projects
  • Professional-Family Relations
  • Professional-Patient Relations
  • Truth Disclosure*