Humanising processes after harm part 2: compounded harm experienced by patients and their families after safety incidents
BackgroundHealthcare organisations risk harming patients and their families twofold. First, through the physical, emotional and/or financial harm caused by safety incidents themselves, and second, through the organisational response to incidents. The former is well-researched and targeted by interve...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-12-01
|
| Series: | Frontiers in Health Services |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/frhs.2024.1473296/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850063807312822272 |
|---|---|
| author | Lauren Ramsey Joanne Hughes Debra Hazeldine Sarah Seddon Mary Gould Jo Wailling Jenni Murray Siobhan McHugh Ruth Simms-Ellis Ruth Simms-Ellis Daisy Halligan Katherine Ludwin Jane K. O’Hara |
| author_facet | Lauren Ramsey Joanne Hughes Debra Hazeldine Sarah Seddon Mary Gould Jo Wailling Jenni Murray Siobhan McHugh Ruth Simms-Ellis Ruth Simms-Ellis Daisy Halligan Katherine Ludwin Jane K. O’Hara |
| author_sort | Lauren Ramsey |
| collection | DOAJ |
| description | BackgroundHealthcare organisations risk harming patients and their families twofold. First, through the physical, emotional and/or financial harm caused by safety incidents themselves, and second, through the organisational response to incidents. The former is well-researched and targeted by interventions. However, the latter, termed ‘compounded harm’ is rarely acknowledged.AimsWe aimed to explore the ways compounded harm is experienced by patients and their families as a result of organisational responses to safety incidents and propose how this may be reduced in practice.MethodsWe used framework analysis to qualitatively explore data derived from interviews with 42 people with lived or professional experience of safety incident responses. This comprised 18 patients/relatives, 16 investigators, seven healthcare staff and one legal staff. People with lived and professional experience also helped to shape the design, conduct and findings of this study.FindingsWe identified six ways that patients and their families experienced compounded harm because of incident responses. These were feeling: (1) powerless, (2) inconsequential, (3) manipulated, (4) abandoned, (5) de-humanised and (6) disoriented.DiscussionIt is imperative to reduce compounded harm experienced by patients and families. We propose three recommendations for policy and practice: (1) the healthcare system to recognise and address epistemic injustice and equitably support people to be equal partners throughout investigations and subsequent learning to reduce the likelihood of patients and families feeling powerless and inconsequential; (2) honest and transparent regulatory and organisational cultures to be fostered and enacted to reduce the likelihood of patients and families feeling manipulated; and (3) the healthcare system to reorient towards providing restorative responses to harm which are human centred, relational and underpinned by dignity, safety and voluntariness to reduce the likelihood of patients and families feeling abandoned, de-humanised and disoriented. |
| format | Article |
| id | doaj-art-ab4b4674a4b04482bb79742be040f0d5 |
| institution | DOAJ |
| issn | 2813-0146 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Health Services |
| spelling | doaj-art-ab4b4674a4b04482bb79742be040f0d52025-08-20T02:49:29ZengFrontiers Media S.A.Frontiers in Health Services2813-01462024-12-01410.3389/frhs.2024.14732961473296Humanising processes after harm part 2: compounded harm experienced by patients and their families after safety incidentsLauren Ramsey0Joanne Hughes1Debra Hazeldine2Sarah Seddon3Mary Gould4Jo Wailling5Jenni Murray6Siobhan McHugh7Ruth Simms-Ellis8Ruth Simms-Ellis9Daisy Halligan10Katherine Ludwin11Jane K. O’Hara12Yorkshire and Humber Patient Safety Research Collaboration, Bradford Institute for Health Research, Bradford, United KingdomPatient and Family Advisory Group, University of Leeds, Leeds, United KingdomPatient and Family Advisory Group, University of Leeds, Leeds, United KingdomPatient and Family Advisory Group, University of Leeds, Leeds, United KingdomPatient and Family Advisory Group, University of Leeds, Leeds, United KingdomFaculty of Health, Victoria University of Wellington, Wellington, New ZealandYorkshire and Humber Patient Safety Research Collaboration, Bradford Institute for Health Research, Bradford, United KingdomSchool of Humanities and Social Sciences, Leeds Beckett University, Leeds, United KingdomYorkshire and Humber Patient Safety Research Collaboration, Bradford Institute for Health Research, Bradford, United KingdomSchool of Psychology, University of Leeds, Leeds, United KingdomYorkshire and Humber Patient Safety Research Collaboration, Bradford Institute for Health Research, Bradford, United KingdomResearch and Innovation, Midlands Partnership NHS Foundation Trust, Stafford, United KingdomSchool of Healthcare, University of Leeds, Leeds, United KingdomBackgroundHealthcare organisations risk harming patients and their families twofold. First, through the physical, emotional and/or financial harm caused by safety incidents themselves, and second, through the organisational response to incidents. The former is well-researched and targeted by interventions. However, the latter, termed ‘compounded harm’ is rarely acknowledged.AimsWe aimed to explore the ways compounded harm is experienced by patients and their families as a result of organisational responses to safety incidents and propose how this may be reduced in practice.MethodsWe used framework analysis to qualitatively explore data derived from interviews with 42 people with lived or professional experience of safety incident responses. This comprised 18 patients/relatives, 16 investigators, seven healthcare staff and one legal staff. People with lived and professional experience also helped to shape the design, conduct and findings of this study.FindingsWe identified six ways that patients and their families experienced compounded harm because of incident responses. These were feeling: (1) powerless, (2) inconsequential, (3) manipulated, (4) abandoned, (5) de-humanised and (6) disoriented.DiscussionIt is imperative to reduce compounded harm experienced by patients and families. We propose three recommendations for policy and practice: (1) the healthcare system to recognise and address epistemic injustice and equitably support people to be equal partners throughout investigations and subsequent learning to reduce the likelihood of patients and families feeling powerless and inconsequential; (2) honest and transparent regulatory and organisational cultures to be fostered and enacted to reduce the likelihood of patients and families feeling manipulated; and (3) the healthcare system to reorient towards providing restorative responses to harm which are human centred, relational and underpinned by dignity, safety and voluntariness to reduce the likelihood of patients and families feeling abandoned, de-humanised and disoriented.https://www.frontiersin.org/articles/10.3389/frhs.2024.1473296/fullpatient safetypatient involvementcompounded harmhealthcare harmsafety investigationshealthcare litigation |
| spellingShingle | Lauren Ramsey Joanne Hughes Debra Hazeldine Sarah Seddon Mary Gould Jo Wailling Jenni Murray Siobhan McHugh Ruth Simms-Ellis Ruth Simms-Ellis Daisy Halligan Katherine Ludwin Jane K. O’Hara Humanising processes after harm part 2: compounded harm experienced by patients and their families after safety incidents Frontiers in Health Services patient safety patient involvement compounded harm healthcare harm safety investigations healthcare litigation |
| title | Humanising processes after harm part 2: compounded harm experienced by patients and their families after safety incidents |
| title_full | Humanising processes after harm part 2: compounded harm experienced by patients and their families after safety incidents |
| title_fullStr | Humanising processes after harm part 2: compounded harm experienced by patients and their families after safety incidents |
| title_full_unstemmed | Humanising processes after harm part 2: compounded harm experienced by patients and their families after safety incidents |
| title_short | Humanising processes after harm part 2: compounded harm experienced by patients and their families after safety incidents |
| title_sort | humanising processes after harm part 2 compounded harm experienced by patients and their families after safety incidents |
| topic | patient safety patient involvement compounded harm healthcare harm safety investigations healthcare litigation |
| url | https://www.frontiersin.org/articles/10.3389/frhs.2024.1473296/full |
| work_keys_str_mv | AT laurenramsey humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT joannehughes humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT debrahazeldine humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT sarahseddon humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT marygould humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT jowailling humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT jennimurray humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT siobhanmchugh humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT ruthsimmsellis humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT ruthsimmsellis humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT daisyhalligan humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT katherineludwin humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents AT janekohara humanisingprocessesafterharmpart2compoundedharmexperiencedbypatientsandtheirfamiliesaftersafetyincidents |