The government has released the new open disclosure framework for aged care operators, to help them communicate openly when things don’t go according to plan.
“Mistakes will happen, no system is perfect, but it’s how you actively deal with them that’s important,” Craig Gear, chief executive officer of the Older Persons Advocacy Network, told HelloCare.
What is open disclosure?
Open disclosure is the “open discussion” aged care providers have with consumers when something goes wrong that has harmed, or had the potential to cause harm, to a consumer.
It refers to the practice of communicating with consumers when things go wrong, addressing all needs and concerns and, importantly, apologising.
Open disclosure also involves explaining to the consumer the steps the provider has taken to prevent such an incident from happening again.
Open disclosure can involve the consumer’s family, carers, support people and representatives if they would like them to be involved.
With more than 1.3 million people receiving aged care services in Australia, clear, honest and open communication is central to the provision of these services.
Open disclosure helps to build trust
Dr Sarah Russell, founder of Aged Care Matters, told HelloCare open disclosure helped her come to trust the operator when her mother lived in an aged care facility.
“Open disclosure helps to develop trust between staff at an aged care home and residents and their families. This was evident at Mum’s aged care home.
“I had faith in the care Mum received because the registered nurses and manager contacted me (as Mum’s medical power of attorney) whenever an adverse incident occurred, irrespective of the seriousness of the adverse event.”
Guidelines are “a good start”
“I think it’s a good start,” said Mr Gear.
“I think it’s a very important concept that has been a long time coming, but very much needed.”
He said the guidelines will help operators, but how leadership and management embed open disclosure “as a culture” will be the most important determinant of how it works in practice.
“People need to be able to be trained in open disclosure and they need to feel comfortable for the purpose of doing it.
“It’s about the transparency. It’s about communication. And it’s about the action you’re going to take,” he said.
Open disclosure required under the new standards
Open disclosure is a specific requirement under the new Aged Care Quality Standards, which came into effect on 1 July.
Under Standard 6: Feedback and Complaints, operators are required to use open disclosure when things go wrong.
And under Standard 8: Organisational Governance, providers that have a Clinical Governance Framework are required to use open disclosure.
Open disclosure can also apply in Standards 1, 2 and 3.
Linking open disclosure into an organisation’s procedures will be key to making it work, Mr Gear said.
“It needs to link in with people’s complaints and feedback mechanisms under Standard 6. It’s a key element of how you have a continuous process of improvement, and the continuous process of feedback so you can learn from your mistakes.”
Not enough time to provide training and implement system changes
Aged and Community Services Australia’s chief executive officer, Patricia Sparrow, told HelloCare, she is “pleased” the guidelines are now available, but she said the framework’s introduction did not leave enough time for proper implementation.
“Open disclosure is an important principle and has been in use in the health sector for some time. It can be a powerful approach to achieve transparency between residents and their families and providers.
“However, with the framework released only five days before it comes into effect, there is a lot of work left to do, including training staff and making system changes.”
Mr Gear said more information would be helpful in the implementation of open disclosure.
“This is a journey for organisations,” he said. “They are going to have to take some time to embed this. Is there enough information now? Possibly not.”
Adverse incidents should be publicly reported, expert says
Dr Russell said she would have liked to see the new framework go further.
“In the interests of transparency, all aged care homes and home care providers should be required to report adverse incidents not only to the older person and their family but also on their websites,” she said.
“This will enable older people and their families to make informed decisions when choosing an aged care home or home care provider.”
Dr Russell also said she would also like to see open disclosure legislated, as it is in all public health services in Australia.
“It takes a while for people to become comfortable with it”
Mr Gear saw open disclosure introduced into the health system in the 90s, and he told HelloCare, “It takes a while for people to become comfortable with it”.
“It takes leadership and training for people to do it well, rather than be tokenistic or afraid,” he said.
“I’d be comfortable with organisations seeing this as a journey and to continuously learn.
“I would like to see that it’s not just for the critical incidents, that over time it’s seen where we haven’t met expectations, that this starts to be a way we deal with that.”