About the standard
The Disclosure of Harm (proposed new title: Disclosure of Unexpected Outcomes) standard was published in 2010 and requires review to expand for inclusion of a broader scope of harm. With a continued emphasis on patient care, changes to this standard emphasize the requirement of regulated members to disclose harmful events and when disclosure of near-miss events should be considered.
What’s changed?
- Inclusion of clauses to provide regulated members with parameters regarding harmful event disclosure and consideration of disclosing near-miss events;
- Additional details around to whom, when and how disclosure must be made in various solo and team-based scenarios with a continued emphasis on prioritizing patient care; and
- Additional clauses concerning proper documentation and patient record-keeping processes.
- Addition of a clause to help regulated members navigate when an apology to those affected should be considered, recognizing that in accordance with the Alberta Evidence Act, an apology does not constitute an admission of fault or liability and recognizing that the likelihood of complaints or legal action is significantly reduced when patients receive heartfelt acknowledgement of an adverse/harmful event or unexpected outcome.
View the draft standard
For your convenience, the draft standard has clean and marked copies available.
All ResourcesYour opinion matters
Changes to CPSA’s Standards of Practice impact a physician and physician assistant’s day-to-day practice and the standard of care patients can expect. Your feedback is important to us, as it helps us develop clear, reasonable expectations and helpful, applicable resources. We appreciate the time you take and the input you provide.
CPSA regulated members, partner organizations, other healthcare professionals and Albertans are invited to provide feedback from November 20 to December 20, 2024. Feedback may be provided via survey, email or the comment form on each page.
Anonymized feedback will be considered by Council at their spring meeting. Once amendments are finalized and approved by Council, members will be notified by email and The Messenger newsletter.
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Please share your feedback to assist us in ensuring this standard is relevant to current practice.
Read the draft amendments and share your feedback in any of the following ways:
Other feedback on this standard
The term near miss should not be used as it makes no sense in this context - even though commonly used. A near miss = a hit. So a near miss would actually be an event that resulted in patient harm. As per glossary “close call” should be used
Regarding the Disclosure of Adverse or Unexpected Outcomes, I have several issues with this standard.
1. The name of it. Harm is substantially different than an unexpected outcome. An unexpected outcome could be anything from death to something like "the bacteria we were treating before our cultures returned is actually resistant to that antibiotic so now we have to change the antibiotic" to "it's actually a girl when we thought it would be a boy" to "That lump is not malignant, it is actually benign". All of those might be considered unexpected outcomes but not all of them need to be disclosed and nor are there any harms done with the latter two examples.
2. In section 5, it requires MDs to disclose information to family members and close friends. This is far too broad a definition and also may violate confidentiality. Am I supposed to disclose information to every "close friend" of a patient who died as to why the patient died? If another "close friend" calls my office three weeks after the death of his or her friend asking for information, as it is written, I am compelled to disclose that information to that person, even if I don't really even know who that person is.
3. Near misses - these are not harms and there are several different levels of misses. A clerk mixing up two patients at intake and checking in a patient under the wrong information could lead to a disaster but if it is caught early and the admission cleared up, no harm is done.