Time to tackle real barriers to open disclosure
The barriers to open disclosure must be addressed if an open culture in healthcare is to be achieved, according to a medical protection organisation.
The call from the Medical Protection Society (MPS) comes as the Patient Safety Bill 2018, which provides for open disclosure, continues to receive legislative scrutiny.
When the legislation comes into effect, healthcare providers will have a legal duty to disclose serious patient safety incidents and failure to comply could result in a fine or imprisonment.
MPS, which supports 16,000 healthcare professionals in Ireland, says it welcomes the Government’s desire to build trust and openness between patients and doctors following the CervicalCheck controversy, but believes mandating open disclosure will not tackle the real barriers to behavioural change - such as lack of support from leaders or awareness of existing protections for doctors.
An MPS survey of nearly 500 doctors showed that nearly half (49 per cent) say better support from management would encourage more openness, two in five (42 per cent) are worried apologising is seen as an admission of liability, and 39 per cent believe legal protection for the meaning of an apology would encourage doctors to apologise more readily – even though there is already this protection in Ireland.
Dr Rob Hendry, MPS medical director, said: “MPS has always been of the view that while you can mandate open disclosure through legislation, it may not result in real behavioural change, and indeed fear of criminal prosecution could even lead to a panicked ‘tick-box’ process when something goes wrong. This could mean that patients do not get the sincere apology and explanation that doctors want to provide.
“A cultural shift is needed. Clinicians need to be in an environment where they feel empowered and confident to admit errors, apologise and learn from mistakes. This means no fear of blame or personal recrimination, genuine and visible support from leaders equally committed to the principles of open disclosure, and greater education on existing protections for doctors. Alarmingly, 71 per cent of doctors are not aware that the meaning of an apology has been legally protected in Ireland since 2018.”
Dr Hendry added: “If we are to achieve a truly open, learning culture which ultimately improves patient care, the government must acknowledge and address these barriers before or alongside its legislation. MPS also has a part to play – we stand ready to help the government and ensure these new duties on open disclosure can work for both patients and doctors.”