A slow but significant change has occurred in how healthcare professionals and organizations are expected to respond when something has gone wrong in a patient’s care. In 2001, the US accreditation organization The Joint Commission began to require that healthcare facilities disclose all outcomes of care, including ‘unanticipated outcomes’, to patients. Across the world, the need to be transparent with patients and families when care has not gone well is now recognized as a key element of high-quality safe and patient-centred healthcare. In 2020, the US National Steering Committee for Patient Safety released ‘Safer Together: A National Action Plan to Advance Patient Safety’. One recommendation was that organizations ‘implement and maintain programs for providing appropriate ongoing support in the aftermath of harm’. The following year, the WHO’s ‘Global Patient Safety Action Plan 2021–2030’ emphasized the need to ‘Establish the principle and practice of openness and transparency throughout health care, including through patient safety incident disclosure to patients and families’.

In many countries, hundreds of healthcare organizations are embracing this new paradigm, however, a significant gap still persists. Some organizations have yet to welcome a transparent and accountable approach, and others fail to turn these principles into reliable actions. The performance gap may be linked to the paucity of data regarding how the response to harmful medical errors occurs in actual practice or to a lack of consistent measures that track the success of such programs or to ineffective approaches to implementation or to attitudes still anchored in old models of fear and leadership among other barriers.

Early evidence suggests that healthcare Communication and Resolution Programs (CRPs) can be effective to support patients, help patients retain trust in the healthcare system, care for the caregiver, create learning systems to mitigate future harm, and even lower malpractice-associated costs. However, in order for a field to progress, there is a need for: the development and testing of measures, understanding of causal relations, the development and robust testing of implementation approaches, understanding of adaptations and fidelity to such implementation, and ultimately how to scale and disseminate the ideas and approaches to implement CRPs.

This Research Topic will include manuscripts that aim to address some of the priority areas for the communication, transparency, and safety learning field. This may include quantitative or qualitative research in either clinical or community settings.

Research papers may:
• Empirically test approaches to the implementation of CRP programs;
• Describe methods used to adapt CRPs for their sustainment and the effect on patients, their families, and the health system;
• Validate existing measures or develop valid and reliable measures for the field;
• Describe and/or report prospectively designed CRP interventions;
• Identify and describe the mechanism of action of CRP interventions;
• Report the cost or cost-effectiveness of CRP interventions.

We welcome research from a broad range of settings and populations, including from health systems, physician practices and low, middle, and high-income countries.

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Frontiers in Health Services

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Impact