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A New Structure of Attention?Open Disclosure of Adverse Events to Patients and Their FamiliesUniversity of Technology Sydney, r.iedema{at}uts.edu.au
Australian Commission on Safety and Quality in Health Care
Queensland Health
Queensland Health
University of Technology Sydney This article presents an inquiry into how clinicians realize a health policy reform initiative called Open Disclosure. Open Disclosure mandates that discussions with patients/family and team staff about "adverse events" are now no longer ad hoc, individualized, and without consequences for how the work is done, but planned, collaborative, and leading to systems change. The article presents an empirical analysis of a corpus of interviews about the impact of Open Disclosure on clinicians' practices. It situates Open Disclosure in the context of arguments that health care workers are increasingly expected to do "emotional labor" with patients and their families, in that staff are advised to practise "reflexive listening" as a means of managing patients' and family members' emotions in response to incidents. The analysis suggests that thanks to the intensity of Open Disclosure interactions, clinicians may be introduced to an affective-interactive space that they were hitherto unaware of and unable to enter or attain what Nigel Thrift calls "a new structure of attention."
Key Words: Open Disclosure • apology • adverse event • affect • complexity
This version was published on June
1, 2009 Journal of Language and Social Psychology, Vol. 28, No. 2,
139-157 (2009) |
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