Practising Open Disclosure: clinical incident communication and systems improvement
Practising Open Disclosure: clinical incident communication and systems improvement
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DOI：
10.1111/j.1467-9566.2008.01131.x
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发表时间：
2009-03-01
影响因子：
2.9
通讯作者：
Dunn, Stewart
中科院分区：
文献类型：
--
作者：
Iedema, Rick;Jorm, Christine;Dunn, Stewart
本文探讨了专业人士被引导向其服务的消费者表达歉意的方式，在这种情况下，临床医生向患者道歉。本文重点介绍了美国、加拿大、英国、澳大利亚和其他国家的医疗保健组织正在采用的公开披露政策。公开披露政策要求与患者受害者“公开讨论临床事件”。在澳大利亚，公开披露政策的执行目前正辅之以密集的工作人员培训，包括模拟演员-病人的道歉情景。本文介绍了从这些培训班收集的数据进行分析。分析表明，如何模拟道歉从事一线工作人员在评估其披露的有效性，以及如何工作人员可能因此被引导到调和他们的情感和自反性的情感与他们的组织和专业责任，从而产生所需的组织道歉。文章的结论是，公开披露，除了可能缓解临床医生和消费者之间的紧张关系，也可能影响工作人员的经验，并制定他们的角色，在整个系统的医疗保健组织。
This article explores the way that professionals are being inducted into articulating apologies to consumers of their services, in this case clinicians apologising to patients. The article focuses on the policy of Open Disclosure that is being adopted by health care organisations in the US, Canada, the UK and Australia and other nations. Open Disclosure policy mandates 'open discussion of clinical incidents' with patient victims. In Australia, Open Disclosure policy implementation is currently being complemented by intensive staff training, involving simulation of apology scenarios with actor-patients. The article presents an analysis of data collected from such training sessions. The analysis shows how simulated apologising engages frontline staff in evaluating the efficacy of their disclosures, and how staff may thereby be inducted into reconciling their affective and reflexive sensibilities with their organisational and professional responsibilities, and thereby produce the required organisational apology. The article concludes that Open Disclosure, besides potentially relaxing tensions between clinicians and consumers, may also affect how staff experience and enact their role in the overall system of health care organisation.