The Australian Commission on Safety and Quality in Health Care has released a revised version of the Australian Open Disclosure Framework.
The 2026 Framework "provides a nationally consistent basis for effective communication following unexpected healthcare outcomes and harm", designed to enable all healthcare professionals working within Australian health service organisations to communicate openly with patients when health care does not go to plan.
The Commission's Fact Sheet for practitioners states
Open disclosure principles such as respect, transparency, and empathy are applied daily through good clinical communication - helping to build trust, support patient understanding, and foster a culture of safety and accountability. This factsheet provides a quick reference guide for Australian health service organisations and staff across all settings and sectors on when and how to perform open disclosure, based on the Australian Open Disclosure Framework (revised 2026).
What is open disclosure?
Things can go wrong during health care for many reasons, including human error or system failures. Open disclosure is a principles-based approach to honest, empathetic and timely discussions that involves: • Acknowledging what happened • Apologising or expressing regret • Listening to the patient’s experience • Providing clear information about what happened, next steps and follow-up • Learning to improve care
When should open disclosure be used?
It is important to listen and acknowledge the patient’s experience. Open disclosure is expected when: • Harm has occurred (physical, psychological, or social). Open disclosure may be considered when: • The patient raises concerns • An incident is reported via complaints, feedback, incident management reporting system or surveillance programs • The patient has not suffered harm; open disclosure may still be appropriate. Principles of person-centred open disclosure • Respectful and responsive communication • Compassionate acknowledgement and apology • A restorative process • Cultural safety for Aboriginal and Torres Strait Islander peoples
Open Disclosure: When and how to do it
For health service organisations
Using the words ‘I am sorry’ or ‘we are sorry’ is essential
How to perform open disclosure
1. Initial disclosure
Occurs as soon as possible after recognising harm or potential harm. Key steps: • Acknowledge that care didn’t go as expected • Share known facts (avoid speculation and blame) • Say "I am sorry" or "we are sorry" • Listen to the patient’s experience • Explain next steps and support options • Provide nominated contact position details for follow-up
2. Formal open disclosure
Used for serious harm, unexpected death, or when requested by the patient.
Planning includes: • Selecting a designated open disclosure lead and support team • Identifying patient’s needs (e.g. interpreters, cultural safety) • Scheduling meetings based on patient preferences • Offering independent facilitator (if needed) • Documenting all discussions and outcomes
Support and follow-up • Offer access to counselling, advocacy, and support services for patients and healthcare professionals involved • Discuss ongoing care needs and costs • Provide updates on investigation into the incident and planned system improvements • Ensure continuity through a nominated contact person
Legal protection
All Australian jurisdictions have their own apology laws that protect sincere apologies from being used against clinicians in legal proceedings.