Deakin University
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Patients' and family members' views on how clinicians enact and how they should enact incident disclosure: the "100 patient stories" qualitative study

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journal contribution
posted on 2011-07-01, 00:00 authored by R Iedema, S Allen, K Britton, D Piper, A Baker, C Grbich, A Allan, L Jones, A Tuckett, A Williams, Elizabeth ManiasElizabeth Manias, T H Gallagher
OBJECTIVES: To investigate patients' and family members' perceptions and experiences of disclosure of healthcare incidents and to derive principles of effective disclosure. DESIGN: Retrospective qualitative study based on 100 semi-structured, in depth interviews with patients and family members. SETTING: Nationwide multisite survey across Australia. PARTICIPANTS: 39 patients and 80 family members who were involved in high severity healthcare incidents (leading to death, permanent disability, or long term harm) and incident disclosure. Recruitment was via national newspapers (43%), health services where the incidents occurred (28%), two internet marketing companies (27%), and consumer organisations (2%). MAIN OUTCOME MEASURES: Participants' recurrent experiences and concerns expressed in interviews. RESULTS: Most patients and family members felt that the health service incident disclosure rarely met their needs and expectations. They expected better preparation for incident disclosure, more shared dialogue about what went wrong, more follow-up support, input into when the time was ripe for closure, and more information about subsequent improvement in process. This analysis provided the basis for the formulation of a set of principles of effective incident disclosure. CONCLUSIONS: Despite growing prominence of open disclosure, discussion about healthcare incidents still falls short of patient and family member expectations. Healthcare organisations and providers should strengthen their efforts to meet patients' (and family members') needs and expectations.

History

Journal

BMJ

Volume

343

Article number

d4423

Pagination

1 - 9

Publisher

BMJ Publishing Group

Location

London, Eng.

eISSN

1756-1833

Language

eng

Publication classification

C Journal article; C1 Refereed article in a scholarly journal

Copyright notice

2011, The Authors