Transparency is a Rising Tide in the COVID-19 Battle

Added on Mar 31, 2020

By Tejal Gandhi, MD, MPH, CPPS, Chief Safety and Transformation Officer

t_ghandi_sbTransparency is foundational to patient safety, and its importance cannot be overstated in our fight against COVID-19. It is only through the uninhibited flow of information that we can ensure patient and workforce safety. Care providers must feel free to talk openly about risks and harms with colleagues and patients and within and across organizations in order to combat this pandemic. This means deliberately and consistently breaking down the barriers to full transparency, such as fears about conflict, disclosure, and potential negative effects on reputation and finances; lack of leadership commitment; and lack of reliable data.

Colleagues and I have described four interrelated domains of transparency,[1] all of which are essential to our fight against the COVID-19 pandemic and which we see emerging in response to this crisis.

1. Transparency between clinicians and patients

Clinicians are being fully transparent with patients about symptoms of COVID-19 and populations at high risk. In conversations about shifting clinical care to telemedicine or rescheduling elective surgeries, providers are openly discussing with patients the risks and benefits of these changes and why they are necessary.

2. Transparency among colleagues

Among clinicians, there are numerous examples of colleagues contacting other colleagues to share and learn. Ad hoc collaboratives of infectious disease physicians and nurses, health care leaders, and others are being developed to share experiences, best practices, and support. For example, leaders and clinicians in Washington state are sharing their experiences caring for some of the earliest cases of the virus in the United States, offering colleagues across the country guidance for handling issues such as triage, treatment, and telehealth. This type of clinical crowdsourcing is fueling the innovation and collaboration needed to attack COVID-19 on all fronts.

3. Transparency among organizations

At the national and state levels, guidance has been forthcoming from the CDC, the WHO, state Departments of Health, and others. And hospitals and health systems have emergency preparedness mechanisms, impromptu networks with other organizations, patient safety organizations, and other methods to plan for what is coming, to ask for help from colleagues, to learn and share best practices, and to support each other. The concerns about the pandemic greatly outweigh fears of transparency that could otherwise hamper optimal collaboration.

4. Transparency with the public

Health care, government, and community leaders are communicating with incredible transparency to the public about risks, health care limitations, and ways the community can and must partner in slowing the rates of infection. The now ubiquitous concept of flattening the curve is a great example of how complex health care information can be communicated to the public in digestible ways.

These examples prove that the health care system and health care colleagues have the ability and desire to be fully transparent for the collective good. We are seeing that transparency can be the rising tide that lifts all boats in the fight against COVID-19. This willingness to share vulnerability and work together is reassuring and reaffirms all that is good about health care and humanity. This transparency will help get us through the current crisis. It will also support our understanding of the importance of the free flow of honest communication in achieving safe, high-quality, and equitable health care well beyond COVID-19.

Thank you to all caregivers for your commitment to transparent, responsive, and clear communications during this challenging time.

Visit our dedicated COVID-19 webpage for additional resources.


[1] Shining a Light: Safer Health Care Through Transparency. Boston: National Patient Safety Foundation, 2015.