title: Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review.
abstract: OBJECTIVE
  We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI).
  
  
  METHODS
  We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them.
  
  
  RESULTS
  There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI.
  
  
  CONCLUSIONS
  The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required.
authors.affiliation: Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Minsu
authors.identifier: 0000-0001-9949-9224
authors.initials: M
authors.lastname: Ock
authors.affiliation: Department of Medicine, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: So Yun
authors.identifier: 0000-0002-5647-3718
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Min-Woo
authors.identifier: 0000-0002-4574-1318
authors.initials: MW
authors.lastname: Jo
authors.affiliation: Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Sang-Il
authors.identifier: 0000-0002-1068-7542
authors.initials: SI
authors.lastname: Lee
mesh_terms: D016208:Databases, Factual; D006801:Humans; D019300:Medical Errors; D061214:Patient Safety; D010820:Physicians / Q000523:psychology
keywords: Disclosure of patient safety incidents; Medical errors; Patient safety; Systematic review