Professor Tom Gallagher presentation – October 2012 (First International Incident Disclosure Conference, 4-6 October 2012, University of Technology, Sydney)
Professor Gallagher is practising physician and Associate Professor of Medicine at the University of Washington and is renowned for his work in the field of open disclosure.
Tom Gallagher presentations – June 2009
In June 2009, he visited Australia to collaborate with the team working on the 100 patient stories project. He also gave presentations in three states, and these presentations are now available.
Open disclosure practice has been implemented in healthcare services around the world. Many healthcare quality and safety advocacy and support agencies have developed resources to assist in conducting and implementing open disclosure.
Click on the links to find out more.
The Institute for Healthcare Improvement (IHI) Open School contains a series of on line courses and learning modules related to patient safety and quality improvement in health care. One of the modules, PS 105 ‘Communicating with patients after adverse events’ , teaches participants about open disclosure following healthcare harm (Note the IHI charges a fee for most enrolments).
This paper from the New England Journal of Medicine discusses the difficulties that arise when clinicians discover harmful incidents involving colleagues, and how to communicate these errors to the patient. Anxiety about how a colleague will react to the information, along with strong cultural norms around seniority and fellowship may deter such conversations. This paper identifies the importance of initiating a disclosure conversation as well as the importance of institutions creating a culture of trust to ensure transparency. View the supplementary video here.
The Australian Open Disclosure Framework provides some guidance for this type of situation (see sections 2.5 and 7.4)
The Commission has funded two comprehensive literature reviews into open disclosure:
Both reviews were carried out by the Centre for Health Communication at the University of Technology Sydney.
In February 2014 the PROMISES Project (Proactive Reduction of Outpatient Malpractice: Improving Safety, Efficiency, and Satisfaction), a collaboration led by the Massachusetts Department of Public Health released the statement, When Things Go Wrong in the Ambulatory Setting.
This is further to the recommendations for hospitals regarding error disclosure and apology from the 2006 Harvard Hospitals consensus statement, When things go wrong.
Both statements suggest that open disclosure is the essential first step to learning from medical errors and adverse events that may have harmed patients and families.