Quality Care and Patient Safety: A Best Practice Model for Medical Error Disclosure

Over recent years, adverse events and medical errors have become topics of increased concern in health care. Despite the efforts of healthcare organizations and providers to prevent medical errors and adverse events, medical errors are still inevitable. Disclosure of an adverse event is essential in managing a medical error's consequences. We have previously reviewed disclosure policies at the provincial level and found no uniform approach to disclosure in Canada. Effective communication between healthcare providers, patients, and their families throughout the disclosure process is vital in supporting and fostering the physician-patient relationship. Given the variability of medical error disclosure policies, comparing the disclosure process between different health authorities may allow us to better understand the best practice model given the proper parameters. Disclosure policies can provide a framework and guidelines for appropriate disclosure, leading to more transparent practices. The purpose of this study is to review and compare the disclosure policies implemented by individual health authorities across Canada. We will evaluate each policy based on the inclusion of the following key points: avoidance of blame; support to the staff; an apology or expression of regret; avoidance of speculation; some form of patient support; education/training to healthcare workers; immediate disclosure; team-based approach; accessibility; and documentation. The clinical significance of the study is to find similarities and differences between various health regions' policies of disclosure as well as report the best practice model for medical error disclosure across Canada. We suggest implementing a uniform national policy that addresses errors in a non-punitive manner and respects the patient's right to an honest disclosure. A prime role exists for the accrediting and regulatory authorities to initiate policy changes and appropriate reforms in the area. Not only should disclosing medical errors be a routine part of medical care to enhance quality improvement, but it would also protect patients' health and autonomy.