Estratégias para a implementação de políticas de disclousure em hospitais: uma revisão integrativa.

Abstract

Introduction: Patient safety is a global health challenge, with adverse events (AE) being one of the leading causes of death and disability. The concept of disclosure in hospitals has been used to improve communication about these events, promoting transparency among health professionals, patients and their families, thus making it necessary to know the disclosure strategies used by hospitals. Objective: The objective of this study is to map the institutional strategies used to implement disclosure policies in hospitals. Method: This is an integrative literature review, carried out in five stages: problem identification, literature search, definition of the information to be extracted from the selected studies, categorization of studies, and privacy and data privacy. Databases such as LILACS, SCIELO, MEDLINE, PubMed and Google Scholar, among others, were used. The inclusion criteria were full articles, in English, Portuguese or Spanish, published between 2019 and 2024. Result: The review detected 3407 publications, but only 4 articles that addressed the practice of disclosure in different contexts were included. It was shown that the implementation of disclosure policies still faces significant challenges, especially in low- and middle-income countries. Although some hospitals have partially adopted these practices, many still face difficulties in full implementation. The main barriers include the lack of knowledge and training on the disclosure process, in addition to a punitive culture that often discourages transparency. Discussion: The practice of disclosure, although recognized as essential for patient safety, is still poorly adopted in many health institutions. Conclusion: The implementation of disclosure policies is a crucial strategy for implementing patient safety, but it still faces considerable challenges, such as the lack of training and an adequate institutional culture. Promoting a culture of transparency, combined with investment in continuing education for health professionals, can facilitate the implementation of these practices and, consequently, improve the quality of patient care.