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Open disclosure ‘is happening’ – SCA clinical risk head

As reported by the Medical Independent (MI) in July, an evaluation report found “disappointing” involvement and leadership from clinicians during an open disclosure pilot at two of Ireland’s biggest hospitals. The pilot at Cork University Hospital and the Mater Hospital, Dublin, took place between 2010 and 2012, and an open disclosure policy was published by the HSE and SCA in late 2013. The evaluation report also underlined that fear of litigation was a “major barrier” to engaging in the open disclosure process.

Speaking to MI at the SCA’s recent conference on quality, patient safety, and clinical risk, Dr Slattery commented: “Speaking as a paediatrician myself, I think that open disclosure is practiced and has been practiced; it is just that now we are putting more of a label on it.”

She said open disclosure involves saying sorry, finding out what went wrong, informing the person of this, and preventing it from happening again. Dr Slattery noted that adverse events could occur with or without medical error. “I think (open disclosure) is more active than we are led to believe,” she added.

However, some doctors appear to be concerned that an apology could be construed as an admission of liability. “I don’t know whether legislation to protect the apology will make a difference (in attitudes), but I think it will help a little bit, to give the doctor some security in saying ‘I am sorry this has happened’….”

Dr Slattery added that protective legislation around an apology would also re-enforce the idea that the Government is behind the process.

The Government has committed to introducing legislation to support open disclosure. Separately, the Health Information and Patient Safety Bill will provide for mandatory external reporting of serious reportable events (SREs).

Earlier at the SCA conference, Minister for Health Simon Harris confirmed that the National Patient Safety Office will be established in his Department later this year.

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