Open disclosure at Mater Health Services, Brisbane

There are many open disclosure success stories in Australia. Mater Health Services in Brisbane is among them.

Mater recognises that openly discussing adverse events and near misses with patients and their families is an integral component of Mater’s Mission and Values, and is openly committed to the principles of open disclosure and the promotion of a safety culture that values transparency, honesty and respect.

Mater’s Clinical Safety and Quality Unit (CSQU) was formed in 2002. The CSQU’s role is broad, and includes responsibility for medico-legal advice relevant to open disclosure. The Mater’s approach to open disclosure has included the introduction of in-house Medico-Legal Counsel to Mater campus in September 2003, and in-house claims management in January 2004.  These staff members play an important role in staff education, early liaison with patients and their families and, where indicated, early resolution of complaints, claims and compensation.

Other steps which Mater has introduced and which are integral to comprehensive implementation of open disclosure include:

1. Engagement of an external contractor, the Cognitive Institute, in May 2004 to advise CSQU on how Mater might design and implement a communications and training package to educate and engage all clinicians in the roll out of open disclosure practices and clinical incident management;

2. Subsequent engagement of the Cognitive Institute to assist with the training of senior clinical colleagues as leaders and mentors in open disclosure and clinical incident communication and management.  This centred on development of advanced clinical communication skills to enable appropriate, open and honest  conversations with patients and their families following serious adverse events; and

3. Development of a service-wide Open Disclosure Policy that was comprehensively promoted across the entire health service.

For the majority of reported clinical incidents, open disclosure now takes place as a matter of course, initiated by the clinicians involved in patient care. Mater recognises that ensuring early and comprehensive disclosure with the patient in relation to an event fosters a good rapport with the patient and their family and which ultimately will have a positive influence on patient clinical care and the rapid resolution of the patient’s concerns.