24 research outputs found

    The role of governing boards in improving patient experience: Attitudes and activities of health service boards in Victoria, Australia

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    The authors sought to determine the attitudes of public health service board members and senior executives toward patient experience and to describe the governance activities of the boards in this area. The study was based on an online survey of 322 board members from 85 public health services and semi-structured interviews with 35 board members and senior executives from 13 public health services in Victoria, Australia. The results showed that while some health service boards had high aspirations and clear plans for improving patient experience, others remained sluggish or even cynically resistant to changing their existing models of care. Interviewees associated with highly active boards described initiatives to improve patient experience at multiple levels in the organisation - from boardroom to bedside. Among less active boards, efforts to improve patient experience tended to be more ad hoc and there was greater uncertainty about how to scale up or systematise. The authors conclude that addressing the gap between the responsibility of boards to address patient experience, and the reality of their governance activities, requires a nuanced understanding of the attitudes and activities of board members. The approaches taken by “positive attitude, high activity” boards could be showcased as exemplars for others

    The federal government commissioner for patient issues in Germany: initial analysis of the user inquiries

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    BACKGROUND: The political objective in many countries worldwide is to give better consideration to the interests of patients within the health system. The establishment of a federal government commissioner for the issues of patients in the health system in Germany in 2004 is part of these endeavours. The structure and field of activities of this institution has been unique so far. This study investigates for the first time the inquiries the commissioner receives from the public. METHODS: A 33% sampling (n = 850) of the written inquiries (correspondence and e-mails) addressed to the commissioner in the first six months of the year 2005 (n = 2580) was investigated. In a procedure comprising combined qualitative and quantitative levels, the material was thematically encoded and the inquiries allocated to the resulting categories (multiple nominations). The results are presented in descriptive form and investigated especially with respect to sex and age-specific differences. The interdependences between the categorized criteria are analysed. RESULTS: The inquirers are equally spread out amongst the sexes (49% women, 51% men). Older persons outweigh the younger (69% over 60 years). In most cases the issues take the form of claims (72%, n = 609). In every fifth inquiry (n = 168) the personal financial burden for health services is considered as being too high; about equally high (n = 159) is the proportion of persons who criticize the communication with health professionals, especially hospitals and doctors' surgeries. Every third who mentions a medical practice uses terms such as "uncertainty" and "anxiety". It is conspicuous that men more often than women write that they feel unfairly treated in the health system (62% vs. 38%, p < 0.05). CONCLUSION: Predominantly older persons seek the assistance of the federal government commissioner for patient issues. Considerable uncertainty and anxiety with respect to services and charges within the system of the German health insurances become evident. It is not possible from the data to draw conclusions concerning the impact of the commissioner's work on the health system. Nor do we gain any knowledge about the usefulness of the service for the individual. Therefore, evaluation of the political impact and the user satisfaction should follow

    Claiming behaviour in a no-fault system of medical injury: a descriptive analysis of claimants and non-claimants

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    Despite few apparent institutional or economic barriers, the proportion of injured patients in NZ who seek compensation after sustaining a compensable injury is very low. Hence, substantial underclaiming occurs in both negligence and no-fault systems. The disproportionately low propensity of elderly, poor and minority patients to seek compensation also appears to be pervasiv. Authors: Marie M. Bismark, Troyen A. Brennan, Peter B. Davis and David M. Studdert

    Correction to: Outcomes of notifications to health practitioner boards: a retrospective cohort study

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    Abstract The original article [1] contains a major error whereby all rates in Table 2 are mistakenly presented as 50% of their true values; this error was caused by a miscalculation in annualising the original values that represented the rates

    Mandatory reports of concerns about the health, performance and conduct of health practitioners

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    Describes the frequency and characteristics of mandatory reports about the health, competence and conduct of registered health practitioners in Australia. Summary Health practitioners are often well placed to identify colleagues who pose risks to patients, but they have traditionally been reluctant to do so. Since 2010, laws in all Australian states and territories require health practitioners to report all “notifiable conduct” that comes to their attention to the Australian Health Practitioner Regulation Agency (AHPRA). Legal regimes in other countries, including New Zealand, the United States and Canada,mandate reports about impaired peers in certain circumstances. However, Australia\u27s mandatory reporting law is unusually far-reaching. It applies to peers and treating practitioners, as well as employers and education providers, across 14 health professions. Notifiable conduct is defined broadly to cover practising while intoxicated, sexual misconduct, or placing the public at risk through impairment or a departure from accepted standards. Mandatory reporting has sparked controversy and debate among clinicians, professional bodies and patient safety advocates. Supporters believe that it facilitates the identification of dangerous practitioners, communicates a clear message that patient safety comes first, encourages employers and clinicians to address poor performance, and improves surveillance of threats to patient safety. Critics charge that mandatory reporting fosters a culture of fear, deters help-seeking, and fuels professional rivalries and vexatious reporting.Concerns have also been raised about the subjectivity of reporting criteria. Australian Medical Association opposed the introduction of the mandatory reporting regime for medical practitioners, citing several of these objections. Little evidence is available to evaluate the veracity of these different views. We sought to provide baseline information on how the regime is working by analysing an early sample of mandatory notifications. Specifically, we aimed to determine how frequently notifications are made, by and against which types of practitioners, and about what types of behaviour
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