7 Steps For Getting Open Disclosure Right in Aged Care

Open disclosure is part of the current aged care quality standards (and will continue to be embedded in the revised standards). It is an expectation of organisations providing government-funded aged care services. In a recent webinar, the Aged Care Quality and Safety Commission noted that in the past 6 months, only one in four incidents recorded across the sector through the Serious Incident Response Scheme (SIRS) had involved the organisation practising open disclosure as part of addressing the incident.

Additionally, when investigated, it was found that less than half of all complaints escalated to the Complaints Commissioner in August 2024 involved the organisation offering an apology to the consumer, a better explanation of what had happened, or following open disclosure practices.

So, what is open disclosure?

Open disclosure is a practice that organisations and their staff should use when something goes wrong in delivering care or services to an older person. It includes a discussion with the older person and their family, a process to resolve the issue or complaint, and steps to prevent the issue from reoccurring.

Open disclosure supports an individual’s rights and is embedded in the code of conduct for aged care. By working with the person, an organisation and their staff can find out how the incident or issue impacts them and how they would like it addressed.

Addressing issues openly and transparently benefits providers by increasing consumers' trust in the organisation. Even where something has gone wrong, studies have found that if a provider and their staff practice open disclosure and actively seek to address the issue in a way that meets the needs and preferences of the older person, they are more likely to remain with or recommend the provider. This is because trust in the provider is retained or regained through the open disclosure process. Additionally, there is a reduced risk of subsequent complaints and litigation when the consumer feels in control and is encouraged to play an active role in identifying solutions.

How do you practise open disclosure?

TIMELINESS

• Follow up with the person as soon as possible after the incident has occurred or a complaint has been raised. This builds trust in the older person that this issue is as important to you as it is for them.

COMMUNICATE

• Involve the person as much as possible from the start.
• Find a safe place to have the initial conversation, ensuring that if they want advocates or other people to be involved, they are included, too.
• Find out how the incident or issue has affected the person.
• Ensure they have an opportunity to ask questions should they have any.
• Use plain language, avoiding jargon and meaningless words.

PROVIDE AN EXPLANATION

• Explain what happened based on what is known at that time.
• Explain why it happened (if you know), and discuss what you are currently doing to address the situation to make things safer or better for the person.
• Explain what will happen next, including any timelines.

APOLOGISE

• An apology is not an admission of fault, nor does it carry liability under legislation. An apology is part of the open disclosure process, so apologise for what has happened or for the expectations that have not been met.
• You should use the words: “I am sorry,” or “we are sorry,” as part of your apology. However, you shouldn’t include an admission of fault or apportion blame.
• An apology helps the person know you want to work with them to improve consumer outcomes and prevent an adverse outcome or issue from happening again.

GET FEEDBACK

• Ask if they are happy with the solutions implemented, have any other suggestions for improving the situation, or if different approaches might be better.
• Listen to the person and their family; don’t simply talk to them; get feedback from them. Open disclosure is a collaborative process.
• The feedback process doesn’t stop there. Check back with the person a few weeks after a new process or change has been implemented to see if they are happy with it. Let them know that if they are not happy with the solution, the organisation is open to continuing to work with them to resolve the matter.

STAFF TRAINING

• No one likes to receive criticism, and staff can feel worried if they receive a complaint from a client. Training your staff to understand that open disclosure is part of providing quality care means they are more likely to report issues and incidents and address complaints with older people as they arise.
• Your staff should be aware of open disclosure and the correct processes, documentation, and timelines for incidents and issues.
• A clear procedure or process to follow that is visible and easy to access helps reinforce training.
• Ensure the topic of Open Disclosure is included in the staff induction and annual training plan.

EXECUTIVE SUPPORT

Staff will not uphold open disclosure processes unless they feel supported by management. Your organisation should view open disclosure as an essential business practice. It should be part of your organisational culture and support the quality improvement process.

• Ensure that the governing body member induction material has clear information about the principle of Open Disclosure.
• Include an agenda item for ‘Feedback and Complaints’ in board meetings. Identify any trends and inform members of outcomes, including open disclosure, direction, training, or required resources.

Transparency is key in aged care. Put yourself in the shoes of the people you support – be open, honest and willing to work towards a positive outcome for all.

Want to know how compliant you are as an organisation? CDCS has a free Quality Audit Readiness diagnostic tool covering key areas, including client communication. This tool will provide a summary of how prepared you are for your next review and steps you could take to improve compliance. Click here to take this free initial assessment.