Hospitals have barriers to being frank with patients

A survey of staff at two of the country’s biggest hospitals found unanimous support for being frank with patients when things go wrong — but nine out of 10 felt there were barriers within the organisation to prevent this.

The survey at Cork University Hospital and Dublin’s Mater Hospital, carried out to assess their safety culture, found fears weak leadership could lead to problems being buried rather than dealt with. Some staff at both sites — the locations for a national pilot programme on open disclosure — were “highly sceptical” the project could succeed in the current organisational climates.

Staff who attended awareness sessions in relation to open disclosure reported too much emphasis on litigation and the potential backlash from it, rather than being honest with the patient because it is “the right thing to do”.

The findings of the survey, obtained by the Irish Examiner under FoI legislation, come at a time of much public disquiet about the lack of transparency in the health service. Last week, an RTÉ investigation revealed how the HSE kept several parents in the dark about the circumstances that lead to the deaths of their babies at a midlands hospital.

Today in the Irish Examiner, we talk to Jean Gaffney and Thomas Hayes about their five-year battle with the HSE before it admitted liability for injuries due to negligence when their baby Dylan was born in 2007.

Solicitor Ernest Cantillon, who represented the Gaffneys, said in his firm’s experience, hospitals and health boards “deny everything and, in some instances, even deny that the patient was in the hospital” but that when it comes “close to a day of reckoning in court”, the hospital and/or doctor “concede that what they did was wrong, and offer to pay compensation”.

The survey at CUH and the Mater, carried out in 2011 with preliminary findings presented in June 2012, found both hospitals were working hard to manage incidents and investigate properly. While there was a “clear commitment to patient safety” some of this was overly bureaucratic. “Boxes are ticked to demonstrate externally that the system is safe, however safety is not integral in the hearts and minds of staff. Staff who highlight issues are tolerated but still unwelcome,” the report said.

From a medical team perspective, the approach was more proactive, with consideration given to what might go wrong and steps being taken before being forced to act.

As part of the two-year pilot (2010-2012), staff were invited to awareness sessions and open disclosure workshops. However, a letter from the National Open Disclosure Project Team to CUH CEO Tony McNamara expressed disappointment about the “low attendance of medical staff”.