Co-designing of Patient Safety Incident Disclosure Process in Primary Healthcare System in Qatar

The importance of disclosing a patient safety incident to the patient involved is recognized. In Qatar, there is no legal requirement for disclosure. The primary health care system in Qatar includes 30 health centers located around the country, managed by the Primary Health Care Corporation (PHCC). Over 63 nationalities of staff deliver care in the health centers, many coming from countries where a disclosure policy is not implemented, and staff would be reluctant to disclose an incident to a patient for fear of reprimand. Many patients who receive care in the health centers come from countries where the health system culture is not open and transparent with patients. PHCC seeks accreditation of the health centers by Accreditation Canada, which has a required organizational practice of disclosure of patient safety incidents. To maintain accreditation, and consistent with PHCC’s strategy to deliver patient and family-centered care, PHCC needed to develop and implement a disclosure policy and process. The policy and process were co-designed by clinical staff working in the health centers and patients, through a focus group and individual interviews. The resulting policy and process focused on communicating disclosure quickly by a multidisciplinary team, providing for quick access to healthcare services by the patient, and fully documenting the disclosure, using a newly developed electronic record. Staff training, coordination with incident reporting and analysis, and ongoing evaluation were key stages of the implementation. The disclosure process has been in place for five years, with only positive feedback from patients and no legal implications.