PP7 – Open disclosure and complaints

Communicating openly and honestly after adverse events (including clinically significant incidents) shows compassion towards patients, improves the practice’s relationships with its patients, and allows patients to be more engaged in their own care.

Patients need to be able to raise concerns or complaints about the quality and safety of care at the practice.

Open disclosure involves a discussion and other exchanges of information that may take place over several meetings. The practice has an obligation to:

• respectfully explain to patients when things go wrong
• express regret or make a genuine apology (if warranted)
• explain what steps the practice has taken so that the mistake is not repeated.

All relevant information (details of the incidents or near misses, along with the discussion and any apology) can be recorded in the patient’s record as per the Australian open disclosure framework.

To meet this criterion, the practice could:

• maintain an open disclosure process, policy and guidelines
• educate and encourage the practice team to follow the process
• discuss open disclosure during induction
• discuss open disclosure at practice team meetings
• introduce quality improvement initiatives based on learnings from incidents and near misses.

Disclosure to the patient following an incident that caused harm benefits both the patient and the practice. Disclosure may also be appropriate where no harm appears to have been caused, especially if there would otherwise be a reasonable likelihood of harm in the future.

Contact the practice’s medical defence organisation and insurer for further guidance and advice about when the practice may need to participate in open disclosure, and what kind of documentation the practice would require for risk management initiatives.

If the practice receives a complaint, try to have the practice team resolve the issue in a reasonable amount of time. If the practice team cannot resolve the complaint, contact the practice’s medical defence organisation for advice on resolving the complaint before any further action is taken.

The practice needs to:

• have a system to record, review and manage complaints
• maintain a complaints register
• advise consumers of the progress and outcome of their complaint
• inform consumers that the practice will always try to resolve complaints directly
• have information available at the practice or website for consumers about how they can escalate a complaint to the relevant state complaints commission.

The practice could:

• create a position description/s that include the responsibility for complaint resolution 
• keep minutes or notes of meetings where consumer complaints have been considered and discussed
• introduce quality improvement initiatives based on complaints made to the practice.