Improving patient safety through disclosure and quality improvement reviews : Renforcer la sécurité des patients par la divulgation et les examens de l'amélioration de la qualité : un rapport de "Bien faire les choses - Forum sur les politiques consacré à l'avancement de l'amélioration de la qualité au Canada", novembre 2010

The purpose of a quality improvement review should not be to single out and blame health care providers, rather to focus on identifying the system and process failures that contribute to the majority of avoidable adverse events. [...] In British Columbia, Québec, Northwest Territories, and Nunavut, the relevant legislation prohibits the disclosure of quality improvement information to anyone outside of the quality improvement committee, with the exception that these records and information may be disclosed to the regulatory authority (College) for the purpose of a hearing concerning the conduct or competence of a member or in [...] Patients should be advised that the intent of the legislation that protects quality improvement information is not to hide facts from them, but rather to allow health care providers a “safe haven” in which to provide their opinions and speculate as to how things could be done differently to improve the system and processes of care. [...] Rather, the judgment in the legal action is based on the court’s interpretation of the facts of the case and the testimony of experts. [...] To do so, physicians and other health care providers recognize the benefits of actively listening to the concerns of patients and families, and responding with respect and compassion in a timely manner.