An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration

Research output: Book/ReportCommissioned report

Standard

An exploration of the implementation of open disclosure of adverse events in the UK : a scoping review and qualitative exploration. / Birks, Yvonne Frances; Harrison, Reema; Bosanquet, Kate; Hall, Jill; Harden, Melissa; Entwistle, Vikki; Watt, Ian; Walsh, Peter; Ronaldson, Sarah Jane; Roberts, David; Adamson, Joy Ann; Wright, John; Iedema, Rick.

NHS National Institute for Health Research, 2014. 220 p. (Health Services and Delivery Research; Vol. 2, No. 20).

Research output: Book/ReportCommissioned report

Harvard

Birks, YF, Harrison, R, Bosanquet, K, Hall, J, Harden, M, Entwistle, V, Watt, I, Walsh, P, Ronaldson, SJ, Roberts, D, Adamson, JA, Wright, J & Iedema, R 2014, An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration. Health Services and Delivery Research, no. 20, vol. 2, NHS National Institute for Health Research. https://doi.org/10.3310/hsdr02200

APA

Birks, Y. F., Harrison, R., Bosanquet, K., Hall, J., Harden, M., Entwistle, V., ... Iedema, R. (2014). An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration. (Health Services and Delivery Research; Vol. 2, No. 20). NHS National Institute for Health Research. https://doi.org/10.3310/hsdr02200

Vancouver

Birks YF, Harrison R, Bosanquet K, Hall J, Harden M, Entwistle V et al. An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration. NHS National Institute for Health Research, 2014. 220 p. (Health Services and Delivery Research; 20). https://doi.org/10.3310/hsdr02200

Author

Birks, Yvonne Frances ; Harrison, Reema ; Bosanquet, Kate ; Hall, Jill ; Harden, Melissa ; Entwistle, Vikki ; Watt, Ian ; Walsh, Peter ; Ronaldson, Sarah Jane ; Roberts, David ; Adamson, Joy Ann ; Wright, John ; Iedema, Rick. / An exploration of the implementation of open disclosure of adverse events in the UK : a scoping review and qualitative exploration. NHS National Institute for Health Research, 2014. 220 p. (Health Services and Delivery Research; 20).

Bibtex - Download

@book{e6f25ce20c354ed6ab408ffdd098ec69,
title = "An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration",
abstract = "Background: In 2009 the UK National Patient Safety Agency relaunched its Being Open framework to facilitate the open disclosure of adverse events to patients in the NHS. The implementation of the framework has been, and remains, challenging in practice. Aim: The aim of this work was to both critically evaluate and extend the current evidence base relating to open disclosure, with a view to supporting the implementation of a policy of open disclosure of adverse events in the NHS. Methods: This work was conducted in three phases. The first phase comprised two focused systematic literature reviews, one summarising empirical research on the effectiveness of interventions to enhance open disclosure, and a second, broader scoping review, looking at reports of current opinion and practice and wider knowledge. The second phase involved primary qualitative research with the objective of generating new knowledge about UK-based stakeholders' views on their role in and experiences of open disclosure. Stakeholder interviews were analysed using the framework approach. The third phase synthesised the findings from the first two phases to inform and develop a set of short pragmatic suggestions for NHS trust management, to facilitate the implementation and evaluation of open disclosure. Results: A total of 610 papers met the inclusion criteria for the broad review. A large body of literature discussed open disclosure from a number of related, but sometimes conflicted, perspectives. Evidential gaps persist and current practice is based largely on expert consensus rather than evidence. There appears to be a tension between the existing pragmatic guidance and the more in-depth critiques of what being consistent and transparent in health care really means. Eleven papers met the inclusion criteria for the more focused review. There was little evidence for the effectiveness of disclosure alone on organisational or individual outcomes or of interventions to promote and support open disclosure. Interviews with stakeholders identified strong support for the basic principle of being honest with patients or relatives when someone was seriously harmed by health care. In practice however, the issues are complex and there is confusion about a number of issues relating to disclosure policies in the UK. The interviews generated insights into the difficulties perceived within health care at individual and institutional levels, in relation to fully implementing the Being Open guidance. Conclusions: There are several clear strategies that the NHS could learn from to implement and sustain a policy of openness. Literature reviews and stakeholder accounts both identified the potential benefits of a culture that was generally more open (not just retrospectively open about serious harm). Future work could usefully evaluate the impact of disclosure on legal challenges within the NHS, best practice in models of support and training for open disclosure, embedding disclosure conversations in critical incident analysis and disclosure of less serious events.",
keywords = "National Health Service, NHS, patient safety, patient safety incidents, open disclosure, Being Open, adverse events, health care, transparency, patients",
author = "Birks, {Yvonne Frances} and Reema Harrison and Kate Bosanquet and Jill Hall and Melissa Harden and Vikki Entwistle and Ian Watt and Peter Walsh and Ronaldson, {Sarah Jane} and David Roberts and Adamson, {Joy Ann} and John Wright and Rick Iedema",
year = "2014",
doi = "10.3310/hsdr02200",
language = "English",
series = "Health Services and Delivery Research",
publisher = "NHS National Institute for Health Research",
number = "20",

}

RIS (suitable for import to EndNote) - Download

TY - BOOK

T1 - An exploration of the implementation of open disclosure of adverse events in the UK

T2 - a scoping review and qualitative exploration

AU - Birks, Yvonne Frances

AU - Harrison, Reema

AU - Bosanquet, Kate

AU - Hall, Jill

AU - Harden, Melissa

AU - Entwistle, Vikki

AU - Watt, Ian

AU - Walsh, Peter

AU - Ronaldson, Sarah Jane

AU - Roberts, David

AU - Adamson, Joy Ann

AU - Wright, John

AU - Iedema, Rick

PY - 2014

Y1 - 2014

N2 - Background: In 2009 the UK National Patient Safety Agency relaunched its Being Open framework to facilitate the open disclosure of adverse events to patients in the NHS. The implementation of the framework has been, and remains, challenging in practice. Aim: The aim of this work was to both critically evaluate and extend the current evidence base relating to open disclosure, with a view to supporting the implementation of a policy of open disclosure of adverse events in the NHS. Methods: This work was conducted in three phases. The first phase comprised two focused systematic literature reviews, one summarising empirical research on the effectiveness of interventions to enhance open disclosure, and a second, broader scoping review, looking at reports of current opinion and practice and wider knowledge. The second phase involved primary qualitative research with the objective of generating new knowledge about UK-based stakeholders' views on their role in and experiences of open disclosure. Stakeholder interviews were analysed using the framework approach. The third phase synthesised the findings from the first two phases to inform and develop a set of short pragmatic suggestions for NHS trust management, to facilitate the implementation and evaluation of open disclosure. Results: A total of 610 papers met the inclusion criteria for the broad review. A large body of literature discussed open disclosure from a number of related, but sometimes conflicted, perspectives. Evidential gaps persist and current practice is based largely on expert consensus rather than evidence. There appears to be a tension between the existing pragmatic guidance and the more in-depth critiques of what being consistent and transparent in health care really means. Eleven papers met the inclusion criteria for the more focused review. There was little evidence for the effectiveness of disclosure alone on organisational or individual outcomes or of interventions to promote and support open disclosure. Interviews with stakeholders identified strong support for the basic principle of being honest with patients or relatives when someone was seriously harmed by health care. In practice however, the issues are complex and there is confusion about a number of issues relating to disclosure policies in the UK. The interviews generated insights into the difficulties perceived within health care at individual and institutional levels, in relation to fully implementing the Being Open guidance. Conclusions: There are several clear strategies that the NHS could learn from to implement and sustain a policy of openness. Literature reviews and stakeholder accounts both identified the potential benefits of a culture that was generally more open (not just retrospectively open about serious harm). Future work could usefully evaluate the impact of disclosure on legal challenges within the NHS, best practice in models of support and training for open disclosure, embedding disclosure conversations in critical incident analysis and disclosure of less serious events.

AB - Background: In 2009 the UK National Patient Safety Agency relaunched its Being Open framework to facilitate the open disclosure of adverse events to patients in the NHS. The implementation of the framework has been, and remains, challenging in practice. Aim: The aim of this work was to both critically evaluate and extend the current evidence base relating to open disclosure, with a view to supporting the implementation of a policy of open disclosure of adverse events in the NHS. Methods: This work was conducted in three phases. The first phase comprised two focused systematic literature reviews, one summarising empirical research on the effectiveness of interventions to enhance open disclosure, and a second, broader scoping review, looking at reports of current opinion and practice and wider knowledge. The second phase involved primary qualitative research with the objective of generating new knowledge about UK-based stakeholders' views on their role in and experiences of open disclosure. Stakeholder interviews were analysed using the framework approach. The third phase synthesised the findings from the first two phases to inform and develop a set of short pragmatic suggestions for NHS trust management, to facilitate the implementation and evaluation of open disclosure. Results: A total of 610 papers met the inclusion criteria for the broad review. A large body of literature discussed open disclosure from a number of related, but sometimes conflicted, perspectives. Evidential gaps persist and current practice is based largely on expert consensus rather than evidence. There appears to be a tension between the existing pragmatic guidance and the more in-depth critiques of what being consistent and transparent in health care really means. Eleven papers met the inclusion criteria for the more focused review. There was little evidence for the effectiveness of disclosure alone on organisational or individual outcomes or of interventions to promote and support open disclosure. Interviews with stakeholders identified strong support for the basic principle of being honest with patients or relatives when someone was seriously harmed by health care. In practice however, the issues are complex and there is confusion about a number of issues relating to disclosure policies in the UK. The interviews generated insights into the difficulties perceived within health care at individual and institutional levels, in relation to fully implementing the Being Open guidance. Conclusions: There are several clear strategies that the NHS could learn from to implement and sustain a policy of openness. Literature reviews and stakeholder accounts both identified the potential benefits of a culture that was generally more open (not just retrospectively open about serious harm). Future work could usefully evaluate the impact of disclosure on legal challenges within the NHS, best practice in models of support and training for open disclosure, embedding disclosure conversations in critical incident analysis and disclosure of less serious events.

KW - National Health Service

KW - NHS

KW - patient safety

KW - patient safety incidents

KW - open disclosure

KW - Being Open

KW - adverse events

KW - health care

KW - transparency

KW - patients

U2 - 10.3310/hsdr02200

DO - 10.3310/hsdr02200

M3 - Commissioned report

T3 - Health Services and Delivery Research

BT - An exploration of the implementation of open disclosure of adverse events in the UK

PB - NHS National Institute for Health Research

ER -