Open Disclosure

This article discusses the importance of open disclosure in healthcare, the information provided to consumers and clinical staff, and the process involved. It covers topics such as why open disclosure is important, information provided to consumers and clinical staff, level of managerial involvement, and medico-legal and ethical considerations. The article concludes with an outline of the open disclosure process.

Running Head: OPEN DISCLOSURE
Open Disclosure
Name:
Institution:

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Introduction
Open disclosure can be termed as a transparent discussion of things which may end up bringing
damage or harm to a patient during treatment. The discussion would be between the clinical staff
and the family or caretakers of the patient (Berwick, 2016). The harms may be called
misadventures which may be caused by either technical problem or human error, poor timing
during surgery, accuracy and lack of the effectiveness of care(Collins & Varmus, 2015). The
misadventures can be related to medication errors, procedural errors, surgical complication, and
misdiagnosis among others. Open disclosure addresses all this misadventures to make sure that
the family or the caretakers of the victim are satisfied with the consequences. Open disclosure
brings awareness of exactly what happened with the patient hence bringing a clear picture of the
misadventure (Berwick, 2016).This paper will discuss disclosure in depth tackling the processes,
its purpose, duties of the staff and the management involved in open disclosure.
Why open disclosure is important
As per its definition, open disclosure ensures that openness and timely discussions happens
between the victim and the health staff concerned when a misfortune occurs. These discussions
help improve the staff, patient and societal confidence on how this system answers the patient’s
safety occurrences and are important in maintaining the trust between the staff and consumers
(Elliott et al., 2015) There is a great importance of saying sorry especially when a misfortune
occurs; this helps winning back the trust of the community and also maintaining the name of the
healthcare institution involved.
Open disclosure is a core requirement by the professionals in ethical practices and the
institutional responsibility. Here some institutions give it a mandate to offer discussions for any

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misfortune occurring in their healthcare institutions(Holloway & Galvin, 2016). This ensures that
they would be careful when handling the customers because any failure may result to individual
penalties. Open disclosure also helps the patients go through the process that was carried out
during treatment and understand in depth the reasons why the misadventure happened; through
this the family would be somehow satisfied with the situation and may be comforted during time
of sorrow.
Open disclosure also helps the victims and the patient recover what was lost as a result of
misadventure. Through this process all the costs are identified, analyzed and compensated where
applicable (Collins & Varmus, 2015). It will also encourage the customers since they are sure
that they do not lose both the treatment money and fail to get full satisfaction.
Information about open disclosure given to consumers
A consumer should be informed about any event of misadventure that is; when consumer suffers
unintended damage or harm during treatment process or disability services. Any error affecting
the care of the consumer but has not caused any negative effect should also be addressed to the
customer (Holloway& Galvin, 2016). Notifying the error is useful in later care decisions to be
made. The open disclosure should contain the acknowledgement of what happened, a detailed
explanation of the incidence, how this happened, and where it happened if appropriate. It should
also include what measures they have taken to prevent it from happening in later dates.
A disclosure system should have a clear apology which should be sincerely addressed to the
consumers or the victim. This gives an opportunity to say sorry for what happened. Apologies
bringa comfort to the victim which is a key to healing process. In some cases, apology can be
critical to the decision of the consumer to lay a written complaint for further explanation

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(Holloway& Galvin, 2016).Finally, a consumer has right to be given the contacts of the health
center andthe full information of disability advocate of consumers and also the alternatives for
addressing the complaints.
Information about open disclosure given to clinical staff
Clinical staff are the main personnel that actively takes part in treatment of the consumers. The
clinical staff should ensure that they have given full information to the consumers about the open
disclosure (Holloway& Galvin, 2016).This is by using the knowledge acquired from the top
management about the open disclosure when a misadventure happens. Clinical staff should also
be informed that they should make sure that the patient is protected from any kind harm which
may lead to complications to the consumers.
Clinical staff should also understand that they should be well equipped to be answering questions
during open disclosure process. This would enable them to always be ready to deal with any
complications and also be careful when carrying out their operations (Lamb, 2004). They should
also make sure that they apologize to the customer or the caretakers about any safety incident,
without the blame of the cause events. It is also the duty of the clinical officers to make sure that
any case of safety or complains associating with open disclosure is noted down in the victims’
health care book and to the management system involved.
Senior clinical staff should also ensure that appropriate services are given to the patients when
patient safety occurs to avoid more complications (Lamb, 2004).It should also have information
that the current care is given to the customer as a requirement that leads to disclosure. They
should also be informed to keep the records of the safety of the patients’ happenings or any
complain, open disclosure here is made in the customers’ record.

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Level of Managerial Involvement in the Open Disclosure
All the management levels in a health institution are involved in open disclosure process. They
range from the chief executive to the clinical officers.(Lamb, 2004) Clinical excellence
commissions provide the tools for evaluation of the open disclosure process. Health services
board ensures that the open disclosure is done in time and as per the policies and the acting law
(Manser & Staender, 2005).Chief executives ensure that the system and the procedures involved
are well explained to the clinical officers. Senior clinical officers ensure that the good treatment
is done to avoid misadventures. Clinical officers work their best to make sure that they follow
the laid procedures and also get involved in answering questions during open disclosure process.
Apart from that, there are operational managers who are put there to manage open disclosure
system. They are specialists in the field of open disclosure hence are employed to ensure that the
legal procedures are followed during the process (Manser & Staender, 2005) They work their
best to ensure that they promote and put in support of the open disclosure. They are responsible
of choosing those who coordinate the open disclosure process within a given health facilities
with approval of the clinical governance director. They also ensure that free and fair disclosure is
done team is provided when official open disclosure is needed. They finally monitor the process
to ensure that the positive agreement is reached and also the victim is satisfied with what
happened causing misadventure.
Managerial Assistance Required to Support Open Disclosure process

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Managers are the key people to ensure that the disclosure process is done in a proper way or
whether it meets the legal procedure. (Moorthy & Kieny, 2015). The managers should have
conducive environment provided by the departments’ involved in open disclosure process. The
department heads should make sure that the current care is given to the patient as a requirement
by the policies and any request by the family members to change the clinical officer should be
done. Proper education about the open disclosure should also be considered so as to ease the
work of the managers during the process (Manser & Staender, 2005).Managers should also be
assisted with the adequate equipment to be used during the process. The hand books should be
well distributed for reference especially where there is misunderstanding. Management involved
should also make sure that the open disclosure is given to the clinical governance director and
chief executive too. The procedures should also be written in simple language where everybody
involved would be able to understand covering all the illiterate people.
Information Provided to Consumers when misadventure happens
During open disclosure process, health consumers should be provided with crucial information
about what happened that the standards were not met during the process. The people concerned
with the open disclosure process should provide the information with supportiveevidences as to
reason why ithappened. The clinical staff should first apologize for any complexity so that the
victim should at least feel a concern and take heart. The healthcare should acknowledge their
own mistake if it tends to happen.
The healthcare consumer should know the processes that took place which led to misadventure.
He or she should get the advocates contacts to who would help to recover the lose that happened.
Parents who are affected will need ongoing treatment which may be given at the same

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organization. The ongoing treatment should be discussed openly and the agreement should be
written down by both the parties. The consumers should understand any misadventure happened
accidentally and be ready to forgive. In case of death, the healthcare should cater for the death
and give detailed information addressing sorry to the victims. They should cater the cost
associating with the hospital. With this the victims will be satisfied and there will be no more
complains. In case of the dissatisfaction with the open disclosure, the consumer is liable to report
the case for the law to take its action.
Medico-legal and ethical considerations in the open disclosure
Open disclosure is subject to national standards that are put in place in health policy documents.
There is no law obligation that open disclosure to patients when an event occur. There is a line of
common law which aims at supporting open disclosure either as a part of the task or an implied
contract in medical services (Oboho et al., 2015). The disclosure may facilitate the repair or
damage in order to avoid suit for the negligence during treatment. Open disclosure is an implied
contract whereby it is responsible for the healthcare to provide the information concerning the
misadventure happenings
The ethical bases for the disclosure of the vital information to the customers and their caretakers
following the misadventure are the principles of being transparent, truthful honest and respecting
victims’ autonomy while putting the patient’s welfare first.openess and the honesty is the core
bases for the trust relationship which patients tend to have with their professional team and the
institution undergoing medication too (Oboho et al., 2015).
If a misadventure occur requiring further treatment, communication on the facts about the events
is important in ensuring the necessary information to make decisions regarding their case which

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is a part of the consent process. Communicating openly assists the victims make the best and
informed decisions with the available information. The society should be well satisfied with the
way the healthcare is operating.
Rights and responsibilities of clinical staff when adverse event happens
The clinical staff should ensure that they provide the detailed information about what happened
during the process. The clinical staff should ensure that he or she apologizes to the victim and
give an adequate support to the person following the incidence without attribution or blame
about the events.(Oboho et al., 2015) They should also ensure that a misadventure complain
associated with open disclosure is recorded in the patients’ health record and management
system too. They should also ensure that there is no more happenings of the misadventure and
have proper handling of the patients. The clinical staff should also ensure that they participate in
effective open disclosure so that the victims should have the full knowledge about the tragedy.
They are also responsible for notifying the requirement for official open disclosure to the
departments involved and the operations service to take respective action.
Outline of the open disclosure process
In case of any misadventure, the measures should be implemented by the health care which is
believed to be the successful for the disclosure (Manser&Staender, 2005). First you should report
any clinical misadventure to the relevant authority according to the policy of the department.
After that you can notify the patient about the misadventure and make him or her understand the
incidence in time (Manser&Staender, 2005).You can now undertake an investigation concerning
the incidence where you can now give detailed feedback. Finally you can develop plan for what

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should happen next. With the processes, a lot of complaints will be minimized and the
confidence of the healthcare will be maintained.
Conclusion
From the above information, we can draw important conclusions about open disclosure is the
important factor in any health care institution (Patel &Volpp, 2015). With the open disclosure,
patients will be confident when receiving treatments since there is a remedy if misadventure
happens. Clinical staff work with great care since there is a penalty on any fault caused by their
incomptences.The government should make it mandatory for any health institution to operate
with open disclosure system (Manser&Staender, 2005). This will help in minimizing death and
complications in every institutions hence the services offered would be of quality.
With open disclosure, patients and the caretakers will have something to be happy of since they
can regain back the costs occurred due to misfortune (Patel &Volpp, 2015). The council,
executives, management departments and clinical staff should work hand in hand to ensure that
open and transparent disclosure is done. The patients and their families should also collaborate
during the process so that information can be delivered effectively and proper agreement is met.
The hospitals should also cope with the advancing technology to ease the services of the open
disclosure (Patel &Volpp, 2015). They should also clearly explain the processes in a simple way
where everybody will understand. Cases of death if misadventure happens should also be
addressed clearly and the remedies to that. This will help improving health services in the entire

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world and help minimizing deaths maintaining the economy which is a core vision to most
countries.

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