Published: 29 April 2021
Five case scenarios set in different healthcare settings demonstrate some of the complexities that can arise during the open disclosure process and provide guidance to healthcare staff on how to manage each situation.
They are part of Module 2 of the national open disclosure training programme. The HSE launched its Open Disclosure Policy in November 2013. The implementation of this policy has involved an extensive training programme which is being rolled out across all health and social care services.
Open Disclosure training was identified by the Director-General of the HSE in 2018 as mandatory training for all HSE staff and for staff employed in services funded by the HSE.
Open Disclosure: Applying Principles to Practice
Module 2 'Applying Principles to Practise' is a follow on to Module 1 and is particularly aimed at staff such as doctors, managers, patient liaison staff, Quality and patient safety staff, who may have to be involved in formal open disclosure meetings with patients, service users and their families/support persons.
The aim of Module 2 is to prepare staff for the management of a formal open disclosure meeting.
Following completion of the module, staff will:
- have an understanding of the key communication skills involved in undertaking an open disclosure discussion in a manner that is empathic and compassionate and that meets the needs of patients and their families,
- be aware of the key components involved in managing the initial discussion with the patient or relevant person following the patient safety incident,
- know how to prepare for, manage and follow up on a formal open disclosure meeting, and
- be guided in managing some of the complexities that may arise during open disclosure meetings.
Lorraine Reilly, a patient representative and open disclosure advocate shares her own family story and her thoughts on why open disclosure is important to patients and their families.
Based on the feedback received on Module 1, the module contains the five case scenarios in different healthcare settings – the Emergency Department, Ambulance Service, Intellectual Disability Service, General Practice and Mental Health Services. Each case scenario brings different learning components which will benefit all staff. The case scenarios were provided by staff working in these services in an effort to make the scenarios realistic for staff completing the module.
Videos of the initial discussion with a patient’s family following a patient safety incident are included in the modules along with videos of the formal open disclosure meeting. These videos demonstrate how the meeting should be conducted using the ASSIST model of communication. While the videos provide only a snapshot of the meeting they will be of huge benefit for staff in relation to learning and the sample language provided that can be used when managing these difficult conversations with patients and their families.
The module also contains an audio recording of a phone call from the designated person (key contact person) to the family to help them in preparing for the open disclosure meeting.
The module is interactive with continuous learning throughout and with a quiz at the end to assess learning. You will also find links to a number of resources/tools throughout the module aimed to support staff when preparing for and managing a formal open disclosure meeting.
There is an ‘extend my learning’ section at the end of the module with links to a number of other resources. The module includes a reflective tool and reflective components throughout the programme to enable the participant to demonstrate personal reflection and learning – this reflective tool may be used later by some staff groups for their learning portfolio.
Earn CPD and CEU credits
There is a post-completion survey attached to this module when three months after completion of the module staff will be surveyed in relation to the application of the learning from the module to their practice.
The Module has been awarded:
- 3 external Continuing Professional Development (CPD) points by the Royal College of Physicians of Ireland (RCPI).
- 3 Continuing Education Units (CEUs) by Nursing and Midwifery Board of Ireland (NMBI)
Understanding the Concept of Open Disclosure
It is recommended that staff complete Module 1 first to learn the theory that underpins the practical components in Module 2. Module 1 ‘Communicating effectively through Open Disclosure’ was launched by the HSE on HSELanD in April 2020. This is a 40-minute module and provides an overview of open disclosure and the principles. On completion of this module, staff will be aware of their responsibilities in relation to Open Disclosure in line with the HSE policy and processes and be able to contribute to Open Disclosure conversations using the ASSIST model of communication. The module includes an extensive list of resources to support staff when engaging in the open disclosure process.
The development of both modules was overseen by a reference group including patient representatives and the modules were tested by a focus group of staff and their feedback incorporated prior to being launched.
Additional skills training is recommended for those staff who may be involved in formal open disclosure meetings and therefore, following the successful launch of Module 1, the staff in the National Open Disclosure Office worked proactively to progress the development of Module 2.