Patient safety incidents can have an impact on healthcare staff whether or not they were directly involved in the incident. Staff may experience a range of emotional and psychological responses following an incident, including distress, grief, self-doubt, anxiety, or concern about professional reputation.
Participation in open disclosure discussions may also involve exposure to psychosocial hazards such as:
- high emotional demands
- uncertainty
- conflict
- exposure to potentially traumatic events.
These experiences can affect a staff member's psychological health and wellbeing.
While open disclosure helps promote healing and maintaining trust with patients and their families, carers and support people, it can also be a meaningful and restorative process for staff. Participation in open disclosure can support reflection, connection, learning, recovery and professional growth.
Restorative just and learning culture
A restorative just and learning culture encourages honest and transparent conversations, shared learning and continuous improvement. It also helps staff feel safe and supported to participate in open disclosure. Open disclosure should be restorative and trauma-informed for staff as well as patients and their support people.
Health services have a responsibility to:
- identify and manage psychosocial risks associated with work, including from patient safety incidents and open disclosure activities and
- provide appropriate support, supervision, consultation, training and resources throughout the open disclosure process.
Leaders and managers play an important role in supporting staff by:
- recognising signs of psychological distress or cumulative stress
- facilitating access to appropriate support services
- ensuring staff are appropriately prepared for open disclosure discussions
- providing opportunities for debriefing, reflective practice and peer support
- fostering a just, restorative and learning culture where staff feel safe to speak openly and learn from incidents.
Find resources and tools to support staff in the Open Disclosure Handbook.
Common concerns about open disclosure
Some staff may feel uncertain about participating in open disclosure discussions. Common concerns include:
- fear of litigation
- concerns about saying "the wrong thing"
- uncertainty about what information can be shared
- anxiety about discussing harm.
Benefits for staff
For staff, open disclosure can be a meaningful and restorative process that promotes learning and recovery after patient harm has occurred. Participating in open disclosure may:
- help staff heal and recover following an incident
- preserve relationships between healthcare staff and patients and/or their support people
- contribute to a culture of learning and improvement.
Seeking support
Staff experiencing stress following a patient safety incident are strongly encouraged to seek advice and support from available workplace wellbeing services, including your employee assistance program.
Additional support may be available through:
- clinical governance units
- clinical supervision
- mentoring programs
- peer support programs
- cultural support
- reflective practice resources.
Health services will have senior staff who have experience in the open disclosure process who can provide guidance and support before, during and after the process.
Seeking support is an important part of maintaining psychological health following a patient safety incident. Staff should be encouraged to discuss any concerns with their manager or supervisor and access available supports early. Health services should ensure that psychosocial risks associated with patient safety incidents and open disclosure are recognised, monitored and appropriately managed.