Bridging the Gap: Toward a Unified Framework for Transparent and Patient-Centered Error Disclosure

Abstract

Medical error remains a major global patient-safety concern and continues to contribute substantially to morbidity and mortality. Despite sustained international efforts to improve healthcare quality, disclosure of medical errors to patients remains inconsistent and operationally challenging. Although widely accepted as an ethical obligation and a cornerstone of patient and family-centered care, disclosure practices vary considerably across healthcare systems. We have previously described Canadian provincial initiatives promoting open disclosure and advocated for their integration into a no-fault framework. The objective of this study is to conduct a systematic comparative analysis of medical error disclosure policies across Canadian provincial and territorial health authorities and to propose a best-practice medical error disclosure model. Using a structured policy review, we evaluated existing frameworks across five indicators: timeliness and accuracy of communication; the presence of a supportive, non-punitive institutional culture; availability of formal education and training; and coordinated, team-based involvement in disclosure. While most jurisdictions endorse transparent disclosure in principle, substantial variability exists in training requirements, team coordination, and enforcement mechanisms. These inconsistencies contribute to persistent provider uncertainty driven by inadequate preparation, medico-legal concerns, fear of damaging therapeutic relationships, and organizational cultures that do not consistently support transparency. Our findings highlight disclosure as a complex, iterative process requiring alignment of ethical principles, communication strategies, patient safety practices, and institutional support. In the absence of a national framework, we recommend the development of a patient-centered, non-punitive disclosure policy embedded within the standard of care.

Keywords: Quality Care, Patient Safety, Medical Error Disclosure, Culture Of Safety, Patient Centered Care

DOI: 10.54941/ahfe1007483