Communicating openly and honestly with patients and families about unexpected medical events-a policy known as full disclosureimproves outcomes for patients and providers. Although many certification and licensing organizations have declared full disclosure to be imperative, the adoption of and adherence to a full disclosure protocol is not common practice in most clinical settings. We conducted a case study of Ascension Health's implementation of a full disclosure protocol at five labor and delivery demonstration sites. Twenty-seven months after implementation, the rate of full disclosure had increased by 221 percent. Practitioners saw insurers' acceptance of the full disclosure protocol, consistent and ongoing leadership by local practitioners and hospitals, the establishment of a well-trained local investigation and disclosure team, and disclosure training for practitioners as key catalysts for change. Lessons learned from this multisite initiative can inform liability insurers and guide providers who are committed to ensuring that full disclosure becomes the only response to unexpected medical events.

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This statement articulates a consensus of participants in a colloquium organized and sponsored by Ascension Health. The purpose was to consider what, if any, clinical interventions would be consistent with the Catholic moral tradition in the event that a woman's life is threatened because her body is unable to adapt to the changes associated with pregnancy because of a preexisting pathology. An example is peripartum cardiomyopathy in pregnancy. The consensus is offered for evaluating the morality of medical interventions in such cases and as the basis for developing clinical guidelines consistent with Catholic teaching and the standard of care. The colloquium participants agree that induction before viability to eliminate a grave and present danger posed by a life-threatening condition resulting from the interaction of a normally functioning placenta with diseased organs of the mother can be consistent with Catholic Church teaching and the moral tradition.