Open disclosure
Open disclosure is an important step in responding to and resolving adverse events and issues that happen during health care.
What is open disclosure?
Open disclosure provides a structured, person-centred approach to follow when an adverse event results in harm to a person while receiving health care. It involves timely, transparent and compassionate communication with the patient and their chosen support people.
The open disclosure process helps clinicians acknowledge the event, share known facts, outline next steps for review, and discuss actions to prevent recurrence. For health professionals, it is a critical practice for maintaining trust, promoting patient safety, and fostering a culture of accountability and continuous improvement.
The elements of open disclosure are:
- 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 event
- an explanation of the steps being taken to manage the event and prevent recurrence
Health service organisations are required to implement open disclosure as part of our Clinical Governance Standard.
Resources to prepare and respond to open disclosure
- Open disclosure meeting planning and preparation template
- Open disclosure checklist template
- Open disclosure documentation and discussion summary template
- Open disclosure principles, elements and process
- Open disclosure organisational readiness assessment tool
- Patient, family, carer and support person evaluation survey template
- Staff evaluation survey template
- A guide to apologising and expressing regret during open disclosure
- Implementing and practising open disclosure: Guide for health service managers
- Open disclosure: Just-in-time information for clinicians
The Australian open disclosure framework
The Australian open disclosure framework provides a nationally consistent basis for open disclosure in Australian health care.
The framework is designed to enable health service organisations and health professionals to communicate openly with patients when health care does not go to plan.
The framework has been formally endorsed by Australian Health Ministers and the following professional organisations:
- Australian College of Nursing
- Australian and New Zealand College of Anaesthetists
- Royal Australian and New Zealand Colleges of Obstetricians and Gynaecologists
- Royal Australasian College of Physicians
- Royal Australasian College of Surgeons
- Society of Hospital Pharmacists of Australia
It is supported by the:
- Australasian College of Emergency Medicine
- Royal College of Pathologists of Australia
The Royal Australian College of General Practitioners has officially recognised Implementing the Australian Open Disclosure Framework in Small Practices as an accepted clinical resource.
Legal aspects of open disclosure
Apology and/or expressions of regret are central to open disclosure.
All Australian jurisdictions have enacted laws that are designed to protect statements of apology or regret made after ‘incidents’ from subsequent use in certain legal settings.
Health service organisations must consider the legislation in force in the state or territory in which they work when developing open disclosure policies and procedures and training staff.