A Qualitative Study Exploring the Views and Experiences of UK Maternity Healthcare Professionals Towards Adverse Event Disclosure.

Abstract

Objectives: Open and transparent disclosure between health care professionals and patients and/or their families after an adverse event is an important feature of high-quality patient care. Within many countries, disclosure is a legal requirement. Previous research has been well documented within the specialties of surgery and internal medicine, but literature on disclosure within maternity settings is sparse. This study aimed to explore the experiences and views of UK maternity healthcare professionals regarding the disclosure of adverse events.

Methods: Semi-structured interviews were conducted and analyzed using reflexive thematic analysis. Maternity health care professionals (8 midwives and 10 obstetricians), from UK maternity services within the National Health Service (NHS), took part in the study.

Results: Both midwives and obstetricians strongly emphasized the importance of honesty and transparency during disclosure. However, the following barriers were identified, which made the disclosure process challenging: uncertainty about the type of incident that occurred, uncertainty about current disclosure practices, concerns about the investigation process and legal risks, and a lack of support and training regarding disclosure. Five main themes were identified, which described midwives' and obstetricians' views and experiences of disclosure: 'Easing the burden,' 'Role of uncertainty,' 'Fear of vulnerability,' 'Personalization or professionalization,' and 'Need for further support.'

Conclusions: Disclosure is an emotionally demanding task for health care professionals. There is a need for support and guidance during the disclosure process, in understanding legal and regulatory processes, and in approaching disclosure when there is uncertainty about whether an adverse event or complication has occurred.