Accreditation practice pointer: open disclosure
QI3.2 A Our practice follows an open disclosure process that is based on the Australian open disclosure framework.
RACGP Standards for general practice.
The RACGP endorses the Australian open disclosure framework, developed by the Australian Commission on Safety and Quality in Health Care (ACSQHC). According to The Australian Open Disclosure Framework, open disclosure is an open discussion with the patient and their family and carer(s) about adverse events that result in harm to the patient while receiving health care.
Clinicians are required to:
respectfully explain to patients when things go wrong
offer an expression of regret or genuine apology (if warranted)
explain what steps have been taken to ensure that the mistake is not repeated.
In such situations, clinicians and general practices should contact their medical defence organisation and insurers for advice, and what kind of documentation is required for risk management initiatives.
ACSQHC has developed a resource for general practices seeking guidance on implementing an open disclosure framework: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/implementing-australian-open-disclosure-framework-small-practices
General practice can further support the open disclosure process by:
maintaining an open disclosure process and encourage all members of the practice team to follow the process
developing and implementing policies and guidelines that align with the Australian open disclosure framework
keeping a record of any discussions and apologies
implementing quality improvement initiatives (eg develop a brochure to give patients more information about a particular issue)
recording any incidents in the patient’s record
educating practitioners about the Australian open disclosure framework for small practices so that they understand when they might need to undertake open disclosure
discussing open disclosure at practice team meetings.
