What is open disclosure after an adverse event, and what steps should be taken?

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Open disclosure after an adverse event means communicating openly and honestly with the patient and family about what happened, what is known about why it happened, the potential and actual consequences, the immediate actions taken to keep the patient safe, and the plan to prevent recurrence. It includes offering a sincere apology and empathetic support, answering questions, and documenting both the conversation and the event in the medical record. It also requires reporting the incident through the organization’s policy channels and following any regulatory or required reporting.

Steps typically involved are: sharing information in clear, timely language; acknowledging what is known and what isn’t; explaining possible outcomes and uncertainties; outlining concrete actions to prevent recurrence and to monitor the patient; providing available support resources; documenting the disclosure and the event accurately; initiating any required incident or safety reporting; and coordinating with the care team to review the event and implement safety improvements.

This approach respects patient autonomy, maintains trust, and supports learning and system improvement, rather than waiting to be asked, blaming others, or limiting documentation to the chart.