Managing the aftermath of critical incidents: meeting the needs of health-care providers and patients.

Critical incidents may have serious psychological and health-related impact on patients, their families and the health-care providers involved. Exploring the needs of health-care providers and patients and their families in the aftermath of a critical incident, this article highlights a disconnect between the widely acknowledged ethical obligation for open disclosure and current practice, reviews the available evidence on effective disclosure and barriers to open disclosure and provides an overview of what health-care organisations can do to alleviate the impact of critical incidents on staff, patients and their families. The most critical elements are: (1) effective support systems for clinicians, (2) guidelines on critical incident management including immediate measures, disclosure standards and subsequent incident analysis and (3) educational interventions informing staff about disclosure standards and support systems and training critical disclosure skills. Significant leadership commitment is required to successfully implement such comprehensive incident management systems.