Iedema Rick, Sorensen Roslyn, Manias Elizabeth, Tuckett Anthony, Piper Donella, Mallock Nadine, Williams Allison, Jorm Christine
University of Technology Sydney, Australia.
Int J Qual Health Care. 2008 Dec;20(6):421-32. doi: 10.1093/intqhc/mzn043. Epub 2008 Sep 17.
To explore patients' and family members' perceptions of Open Disclosure of adverse events that occurred during their health care.
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.
Four States in Australia: New South Wales, Victoria, Queensland and South Australia.
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.
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.
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.
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.
探讨患者及其家庭成员对医疗过程中发生的不良事件进行公开披露的看法。
我们使用半结构化、开放式指南采访了23名参与不良事件和事件披露的人员。我们采用主题话语分析法对访谈记录进行了分析。
澳大利亚的四个州：新南威尔士州、维多利亚州、昆士兰州和南澳大利亚州。
23名参与者是作为对澳大利亚医疗安全与质量委员会委托进行的澳大利亚公开披露试点评估的一部分而招募的。
所有参与者（除一人外）都对有机会与工作人员会面并听取不良事件的解释表示感激。他们的叙述还揭示了对公开披露实施方式的一些担忧：披露不及时或过于随意；披露后没有提供切实的支持或实践上的改变；工作人员没有道歉，且披露没有为消费者提供与最初涉及不良事件的工作人员会面的机会。
参与者的叙述表明，与缺少其中一个或多个要素相比，正式的公开披露、真诚的道歉以及提供切实的支持相结合，更有可能获得消费者的满意。
工作人员在披露沟通中需要更加关注受害者对不良事件的看法和经历，提供适当的道歉，短期和长期地支持受害者，并考虑利用消费者对不良事件的见解来改进服务。
