Abstract
BackgroundExperience with open disclosure and its study are restricted to certain western countries. In addition, there are concerns that open disclosure may be less suitable in non-western countries. The present study explored and compared the in-depth perceptions of the general public and physicians regarding open disclosure in Korea.MethodsWe applied the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist to this qualitative study. We conducted 20 in-depth interviews and four focus group discussions with 16 physicians and 18 members of the general public. In-depth interviews and focus group discussions were performed according to semi-structured guidelines developed according to a systematic review of open disclosure. We conducted a directed content analysis by analyzing the verbatim transcripts and field notes in accordance with the predetermined guidelines.ResultsOpen disclosure perceptions were summarized in terms of the “five Ws and one H” (who, what, where, when, why, and how). All physician and general public participants acknowledged the normative justifiability of open disclosure. The participants mostly agreed on the known effects of open disclosure, but the physicians had negative opinions on its expected effects, such as decreased intention of the general public to file lawsuits and increased credibility of medical professionals. Generally, the participants thought that open disclosure is required for medical errors causing major harm. However, the physicians and general public had conflicting opinions on the need for open disclosure of near misses. Most physicians did not know how to conduct open disclosure and some physicians had bad experiences due to inappropriate or incomplete open disclosure.ConclusionPhysicians and the general public in Korea acknowledge the need for open disclosure. Guidelines according to the type of patient safety incident are required to encourage physicians to more readily conduct open disclosure. Furthermore, hospitals need to consider organizing a dedicated team and hiring experts for open disclosure.Electronic supplementary materialThe online version of this article (doi:10.1186/s12910-016-0134-0) contains supplementary material, which is available to authorized users.
Highlights
Introduction of open disclosureIn general, a focused improvement in the system and medical environment more effectively improves the level of patient safety than blaming and punishing individuals [33]
This is true in open disclosure and it is difficult for individual medical professionals to conduct open disclosure alone
We cannot exclude the possibility that the in-depth interviews (IDIs) participants and focus group discussions (FGDs) physician participants were not completely open with the researchers and tried to ingratiate themselves with the interviewer in terms of reflexivity. Both physicians and the general public in Korea acknowledge the need for open disclosure of patient safety incidents
Summary
A focused improvement in the system and medical environment more effectively improves the level of patient safety than blaming and punishing individuals [33] This is true in open disclosure and it is difficult for individual medical professionals to conduct open disclosure alone. Guidelines or standards for open disclosure have been developed to facilitate communication on patient safety incidents between medical professionals and patients in several western countries [8,9,10,11]. Medical professionals and the general public should discuss patient safety incidents caused by health care delivery and develop measures to prevent and manage them together [3]. There may be gaps between the perceptions of medical professionals and the general public regarding patient safety incidents, such as the causes of patient safety incidents and their prevention. These gaps in communication could diminish patient trust in medical professionals and patient satisfaction and may increase the likelihood of medical lawsuits [6, 7]
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