Division of Surgery, Department of Surgery & Cancer, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
Postgrad Med J. 2013 May;89(1051):266-73. doi: 10.1136/postgradmedj-2012-000826rep.
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现行做法。
使用在线调查的横断面设计。
负责“公开透明”政策的 209 名患者安全经理（54%的回应率）。
英国国民保健署信托机构。
98%的参与者报告说他们熟悉国家患者安全局的“公开透明”指南，82%的参与者表示在发生事件时，他们会超过一半时间实施该指南。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后 3-6 个月[纠正]进行的。不同严重程度的事件中，承担伤害责任的频率较低，但严重程度较低的事件则显著较低（p<0.001）。长期随访患者和支付特别赔偿金的情况不到一半。对“公开透明”最大的阻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。支持员工的实践，如公开事件后的汇报和培训，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经理高度意识到“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。需要更多研究了解患者和医疗保健专业人员在患者安全事件后的支持偏好。
