Balancing rights and governance: comparative analysis of open disclosure frameworks in Australia and New Zealand

AIM: We aimed to conduct a comparative analysis of the open disclosure frameworks in Australia and New Zealand to identify the strengths, weaknesses and trade-offs of their respective approaches and to propose a hybrid model that integrates the best practices from both systems. METHOD: This qualitative comparative policy analysis systematically reviewed key policy documents from Australia and New Zealand. Data extraction focussed on the principles, processes, governance, legal aspects and implementation strategies of each framework. A multi-theoretical approach was adopted, applying four core theoretical frameworks-institutional theory, regulatory governance, ethics of care and implementation science-to analyse the extracted data. The analysis involved thematic coding, a cross-country comparison through each theoretical lens and a synthesis of the findings to identify the trade-offs between the two models and to inform the development of a refined hybrid model. RESULT: The analysis revealed that Australia's framework, which is embedded in national safety standards, emphasises system-wide governance and accreditation, offering flexibility but at the risk of implementation variability. In contrast, New Zealand's model, which is legally mandated under consumer rights legislation, prioritises individual accountability and patient rights, ensuring strong enforcement but potentially fostering a compliance-driven culture. The key differences between the two frameworks emerged in their legal specificity, enforcement mechanisms and the practicalities of their implementation. The analysis highlighted the critical role of ethical considerations, workforce capacity and organisational readiness for the effective implementation of open disclosure. CONCLUSION: Both the Australian and New Zealand open disclosure frameworks offer valuable insights into the challenge of balancing systemic governance and consumer rights. A hybrid approach that integrates Australia's focus on systemic learning with New Zealand's robust legal mandate for patient rights and explicit ethical considerations could provide a more effective and equitable framework for open disclosure, and could enhance healthcare quality and transparency. Future research should focus on the empirical evaluation of the practical implementation and outcomes of such hybrid models.