Open disclosure for good policy and practice
What’s open disclosure and how should your policies and procedures provide for it?
Ngā Paerewa Health and Disability Services Standard requires an “open disclosure” policy and procedure. So does the Foundation Cornerstone Indicator 1.1.
Here’s what it involves and a couple of options to address it.
What is open disclosure?
Open disclosure means what it says- being open and ready to disclose. But what about?
Not just the good stuff.
Open disclosure means being open about the “not so good” too.
We don’t usually mind talking about what went well. We tend to be more reticent though about what hasn’t gone well. A fear of consequences eg legal action has often encouraged organisations to hide or be secretive about mistakes and errors in treatment and services.
Hence the compliance obligation for agencies subject to the Health and Disability and Cornerstone Foundation Standard to prescribe in open disclosure in policy.
The policy typically deals with what should happen when there’s an adverse impact or error made in treatment or service delivery. If something goes wrong, policy requirements are to own up and apologise.
People should be fully informed about what went wrong and the consequences, treated with empathy and respect, informed about changes made in response to the error (to prevent recurrence) and supported appropriately.
Policy options to address open disclosure
Open disclosure is integral to the protection of other rights in the health and social services like the right to informed consent and the right to exercise self-determination over care. It is also important to an agency making ongoing improvements to the quality of services and care it provides.
The easy way is to provide a specific policy and procedure on open disclosure. We see lots of agencies that do this. It meets their compliance obligations and as a distinct policy, has the benefits of being easily found and clear because it has a narrow focus.
However, our preferred approach is to integrate open disclosure across the policy and procedure suite.
In the Policy Place online policy and procedure system, open disclosure is woven throughout the policy suite to support the service user’s right to have a voice and be an active participant in their own care.
Open disclosure is a core part of the Adverse Incident Management policy and policies addressing informed consent, client participation and client, whānau -/patient-centred practice.
Disclosure about what went right and wrong should also be a subject of ongoing discussion as client and practitioner through the journey of care, service planning, treatment, service delivery and review.
It is key to managing and learning from incidents – because in talking with clients and whānau about what went wrong, we learn from their perspective about what needs fixing and can focus our investigations and improvements on the right things. It also opens up the possibility of making things right – to find out what, if any, support the person or whānau harmed by an error or mistake needs to deal with the impacts.
An integrated approach
Contact us if you like the sound of an integrated approach to open disclosure and joining the online policy system.
Health, disability and social services from across Aotearoa have joined the online policy service to get:
- 24/7 online policies to support their accreditation and compliance obligations
- the assurance of regular reviews and updates
- a one-stop site on which to house their policies and procedures and related documents.
Don’t put off what you can do today.