Health professionals' perceptions and experiences of open disclosure: a systematic review of qualitative evidence
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Date
2014
Authors
Byrth, Jacinta
Editors
Advisors
Aromataris, Edoardo Claudio
McArthur, Alexandra Lee
McArthur, Alexandra Lee
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Abstract
Background: In 1999 the Institute of Medicine released its seminal report ‘To Err is Human; Building a Safer Health System’, drawing worldwide attention to the issue of patient safety in healthcare. Internationally there is a move towards open disclosure as a standard for professional health care practice. It has been suggested that open disclosure plays a pivotal role in achieving a high level of quality of health care and patient safety, as transparency and discussion about errors builds trust between the patient and the health professional and health system. However, studies suggest that there is a significant gap between the level of endorsement of open disclosure of medical errors to patients by health professionals in theory and the actual level experienced by patients in reality. Objective: To synthesise the best available research evidence exploring health professionals’ perceptions and experiences of the barriers and facilitators of open disclosure of medical errors to patients. Design: A systematic review of the qualitative evidence using The Joanna Briggs Institute meta-aggregative approach to qualitative evidence synthesis. Results: Full text review of 41 papers, with the inclusion of nine (9) papers following critical appraisal by two (2) reviewers. A total of 131 findings were extracted and aggregated into 33 categories. Final meta-synthesis generated two (2) key findings; the barriers to open disclosure included personal fears, professional factors, error factors, patient factors, cultural factors, system related and uncertainties; facilitators to open disclosure include professional factors, error factors, system factors, cultural factors and personal needs. Conclusion: The factors impacting on open disclosure by health professionals are varied and complex. Evidence shows a structured approach to the disclosure of errors to patients can assist in removing barriers and enhancing facilitators. Further research is required to investigate the patients’ perspective to ensure the process of disclosing errors is appropriate and patient centered.
School/Discipline
School of Translational Health Science
Dissertation Note
Thesis (M.Clin.Sc.) -- University of Adelaide, Translational Health Sciences, 2014.
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This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals