Week 6

Question 1

What is effective communication

Answer 1

When an intended idea or message is received and understood as intended, then a communication has been successful and effective

Question 2

What does it mean by open disclosure

Answer 2

The process of reporting of adverse events which have resulted in unintended harm to a patient while receiving health-care and the associated investigation and recommendations for improvement

Question 3

What are the five elements of open disclosure

Answer 3

• an apology or expression of regret, which should
include the words ‘I am sorry’ or ‘we are sorry’
• a factual explanation of what happened
• an opportunity for the patient, their family and
carers to relate their experience
• a discussion of the potential consequences of the
adverse event
• an explanation of the steps being taken to manage
the adverse event and prevent recurrence.

Question 4

Can the open disclosure framework only be implemented in acute care facilities? Why or why not

Answer 4

The Framework describes complete, higher level open disclosure. In its entirety it is therefore most directly applicable to high-risk, acute healthcare settings

Question 5

What are the eight guiding principles of open disclosure

Answer 5

1. Open and timely communication
2. Acknowledgement
3. Apology or expression of regret
4. Supporting, and meeting the needs and expectations
   of patients, their family and carers
5. Supporting, and meeting the needs and expectations
   of those providing health care
6. Integrated clinical risk management and systems improvement
7. Good governance
8. Confidentiality

Question 6

What matters are outside of the scope of open disclosure framework

Answer 6

• the informed consent process
• disciplinary proceedings
• large-scale disclosure
• health service organisation human resources management
• clinician training in educational institutions
• incident investigation and quality improvement.

Question 7

What does it mean by matters that are outside of the scope of open disclosure framework

Answer 7

It is important to note that while these matters are outside of the scope of this document, they complement and contribute to effective open disclosure practice

Question 8

What are the workforce responsibilities with open disclosure

Answer 8

 Acknowledging their role in such events and delivering an apology in the form of an expression of regret
 Participating in training and education about open disclosure
 Active participation in open disclosure if the need occurs
 Supporting colleagues after a harmful event has occurred. Blaming and defamatory actions are not to occur. Transparency and openness needs to occur.

Question 9

What are authority gradients

Answer 9

are real or perceived differences between individuals associated with perceived status, authority or expertise that may inhibit another’s ability to speak up

Question 10

Privacy for organisations is regulated by

Answer 10

Privacy Act 1988 and the Information Privacy Act 2014

Question 11

What areas need adaptation of open disclosure

Answer 11

• Rural areas
• Sub-acute sector
• Primary and community-based care
• Mental Health
• Small practices including sole practitioners

Question 12

What incidents require a high level response

Answer 12

1. Death or major permanent loss of function
2. Permanent or considerable lessening of body function
3. Significant escalation of care/ change in clinical management
4. Major psychological or emotional distress
5. At the request of the patient

Question 13

What incidents require a lower level response

Answer 13

1. near miss/ no-harm incident
2. no permanent injury
3. no increased level of care provided
4. no, or minor, psychological or emotional distress