Division of Surgery, Department of Surgery & Cancer, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
BMJ Qual Saf. 2012 Dec;21(12):1001-8. doi: 10.1136/bmjqs-2012-000826. Epub 2012 Sep 26.
To examine the current state of practice in English NHS Trusts in relation to the communication of serious patient safety incidents to patients and families and support for all parties involved.
Cross-sectional design using online surveys.
209 patient safety managers, responsible for the 'Being Open' policy (54% response rate).
English NHS Trusts.
98% of the participants reported that they are familiar with the National Patient Safety Agency Being Open guidance and 82% that they implement it more than half the time when incidents occur. However, provision of timely information was not reported as routine, with two-thirds of the discussions taking place 3-6 months [corrected] after the investigation. The frequency of taking responsibility for harm was low for incidents of different severity levels but significantly lower for less serious ones (p<0.001). Follow-ups of patients in the long term and ex gratia payments were provided less than half the time. The most highly rated barriers to being open were clinical staff's fear of negative reactions from patients or their families and anxiety about litigation. Support practices for staff, such as debriefing and training on being open, were acknowledged as highly important but not always available.
Awareness of the importance of being open is high among patient safety managers in English NHS Trusts, but there is still considerable scope for improvement in the management of the after effects of patient safety incidents. More research is needed on patients' and healthcare professionals' preferences for support after patient safety incidents.
调查英国国民保健署信托机构在向患者和家属通报严重患者安全事件以及为所有相关方提供支持方面的实践现状。
使用在线调查的横断面设计。
209 名负责“公开透明”政策的患者安全经理（回应率为 54%）。
英国国民保健署信托机构。
98%的参与者报告称，他们熟悉国家患者安全局的“公开透明”指南，82%的人在发生事件时超过一半的时间实施该指南。然而，及时提供信息并不是常规做法，三分之二的讨论是在调查结束 3-6 个月后进行的。对于不同严重程度的事件，承担伤害责任的频率较低，但对于不太严重的事件则显著较低（p<0.001）。对患者进行长期随访和给予特惠赔偿的情况不到一半。公开透明的最大障碍是临床工作人员担心来自患者或其家属的负面反应，以及对诉讼的焦虑。对员工进行汇报和公开透明培训等支持性做法被认为非常重要，但并非总是可用。
英国国民保健署信托机构的患者安全管理人员高度意识到公开透明的重要性，但在管理患者安全事件的后果方面仍有很大的改进空间。需要进一步研究患者和医疗保健专业人员在患者安全事件后的支持偏好。
