The National Open Disclosure Pilot: evaluation of a policy implementation initiative.
OBJECTIVE
To determine which aspects of open disclosure "work" for patients and health care staff, based on an evaluation of the National Open Disclosure Pilot.


METHODS
Qualitative analysis of semi-structured and open-ended interviews conducted between March and October 2007 with 131 clinical staff and 23 patients and family members who had participated in one or more open disclosure meetings. 21 of 40 pilot hospital sites, in New South Wales, South Australia, Victoria and Queensland, were included in the evaluation. Participating health care staff comprised 49 doctors, 20 nurses, and 62 managerial and support staff. In-depth qualitative data analysis involved mapping of discursive themes and subthemes across the interview transcripts.


RESULTS
Interviewees broadly supported open disclosure; they expressed uncertainty about its deployment and consequences, and made detailed suggestions of ways to optimise the experience, including careful pre-planning, participation by senior medical staff, and attentiveness to consumers' experience of the adverse event.


CONCLUSIONS
Despite some uncertainties, the national evaluation indicates strong support for open disclosure from both health care staff and consumers, as well as a need to resource this new practice.
Iedema
Rick A M
RA
Faculty of Humanities and Social Sciences, University of Technology, Sydney, Sydney, NSW.
Mallock
Nadine A
NA
Sorensen
Roslyn J
RJ
Manias
Elizabeth
E
Tuckett
Anthony G
AG
Williams
Allison F
AF
Perrott
Bruce E
BE
Brownhill
Suzanne H
SH
Piper
Donella A
DA
Hor
Suyin
S
Hegney
Desley G
DG
Scheeres
Hermine B
HB
Jorm
Christine M
CM
D001315:Australia; D003695:Delivery of Health Care / Q000592:standards*; D005190:Family / Q000523:psychology*; D006291:Health Policy; D015285:Hospital-Patient Relations; D006801:Humans; D007407:Interviews as Topic; D017060:Patient Satisfaction; D010564:Personnel, Hospital; D014342:Truth Disclosure