Being Open
Being open: Communicating patient safety incidents with patients, their families and carers following a patient safety incident.
What is Being open?
Being open provides a best practice framework for all healthcare organisations to create an environment where patients, their carers, healthcare professionals and managers all feel supported when things go wrong and have the confidence to act appropriately. The framework gives healthcare organisations guidance on how
to develop and embed a Being open policy that fits local organisational circumstances.
Being open involves:
- Acknowledging, apologising and explaining when things go wrong
- Conducting a thorough investigation into the incident and reassuring patients, their families and carers that lessons learned will help prevent the incident recurring
- Providing support for those involved to cope with the physical and psychological
consequences of what happened.
It is important to remember that saying sorry is not an admission of liability and is the right thing to do.
Another key part of the framework is the Being open process, which provides advice on how to communicate with patients, their families and carers following harm, based on evidence in the research literature and the experience of other countries.
Underpinning Being open are 10 principles that can be used to promote and disseminate information about openness. These principles can be adapted to meet the structural and resource requirements of individual organisations.
What are the Being open principles?
The principles
The following set of principles has been developed to help healthcare organisations create and embed a culture of Being open:
- Acknowledgement
- Truthfulness, timeliness and clarity of communication
- Apology
- Recognising patient and carer expectations
- Professional support
- Risk management and systems improvement
- Multidisciplinary responsibility
- Clinical governance
- Confidentiality
- Continuity of care
The process
Being open about a patient safety incident is more than a one-off event; it is a communication process with a number of stages. The duration of the process will depend on the incident, the needs of the patient, their family and carers, and how the investigation into the incident progresses
Staff and patient support
NHS Bedfordshire would like to ensure both staff and patients support the implementation of Being open. It is vital that:
- Patients, their families and carers feel confident in the openness of the communication following a patient safety incident, including the provision of timely and accurate information;
- Healthcare professionals understand the importance of openness and feel supported by their healthcare organisation in delivering it. There is evidence to show that openness is supported by patients: when things go wrong patients often want a meaningful apology, explanation, and to get an understanding of how it happened and that it will not happen to others. Further research has shown that patients are more likely to forgive medical errors when they are discussed fully in a timely and thoughtful manner, and that being open can decrease the trauma felt by patients following a patient safety incident.
More information about Being Open can be found on the National Patient Safety Agency website.
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