scholarly journals Responding to Sexual Boundary Notifications: The Evolving Regulatory Approach in Australia

2021 ◽  
Vol 107 (2) ◽  
pp. 25-31 ◽  
Author(s):  
Christine Gee ◽  
Anne Tonkin ◽  
Sharon Gaby ◽  
Veronika Urh ◽  
Sarah Anderson ◽  
...  
Keyword(s):  
Health Care ◽  
Lessons Learned ◽  
Health Practitioner ◽  
Cultural Changes ◽  
Boundary Violation ◽  
Australian Health ◽  
High Profile ◽  
Regulatory Approach ◽  
Independent Review ◽  
Sexual Boundary Violations

ABSTRACT A sexual boundary violation by a health practitioner has an immense impact on a patient, and the trust and confidence in the health care system and the health care regulator are negatively affected. The Australian Health Practitioner Regulation Agency (Ahpra) and the Medical Board of Australia (MBA) in 2017 commissioned an independent review in response to a specific high-profile case of multiple physician-patient* sexual boundary violations. In response to recommendations for process improvement, Ahpra and the MBA worked to transform the regulatory management of sexual boundary notifications.The purpose of this paper is to explore the structural and cultural changes that have been made to manage sexual boundary violation notifications and lessons learned through the process. Three factors — specialized decision-making, training for investigators and policy and cultural changes — were identified as key elements of the change process. Since the changes in 2017, the rate of immediate regulatory action taken in response to sexual boundary notifications has increased substantially, with a higher proportion of decisions resulting in suspension of a physician’s registration. Further work on the experience of those who are part of the notification process and supporting people to share their stories and experiences through the notification and tribunal process is ongoing.

scholarly journals Boundary violation and sexual exploitation in psychiatry and psychotherapy: a review

2004 ◽  
Vol 10 (4) ◽  
pp. 312-320 ◽  
Author(s):  
Sameer P. Sarkar
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Empirical Study ◽  
Sexual Exploitation ◽  
Professional Roles ◽  
Professional Boundaries ◽  
Boundary Violation ◽  
Psychotherapeutic Practice ◽  
The Subject ◽  
Sexual Boundary Violations

In psychiatric and psychotherapeutic practice, ‘boundaries' delineate the personal and the professional roles and the differences that should characterise the interpersonal encounters between the patient/client and the professional. Boundaries are essential to keep both parties safe. The author outlines the various types of boundary violation that can arise in clinical practice, their consequences (both clinical and legal), how professionals can avoid them and how health care institutions might respond, should they occur. He concentrates on sexual boundary violations, because these have been the subject of most empirical study.

A step towards evidence-based regulation of health practitioners

2015 ◽  
Vol 39 (4) ◽  
pp. 483 ◽  
Author(s):  
Marie M. Bismark ◽  
Martin Fletcher ◽  
Matthew J. Spittal ◽  
David M. Studdert
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Workforce Planning ◽  
Care Quality ◽  
Health Practitioner ◽  
Evidence Based ◽  
Australian Health ◽  
Health Practitioners

In 2010 Australia established a national registration and accreditation scheme, covering more than 620000 health practitioners. The data held by the Australian Health Practitioner Regulation Agency is a remarkable platform for research aimed at improving health practitioner regulation, health care quality and workforce planning.

scholarly journals Patient safety, ethics and whistleblowing: a nursing response to the events at the Campbelltown and Camden Hospitals

2004 ◽  
Vol 28 (1) ◽  
pp. 13 ◽  
Author(s):  
Megan-Jane Johnstone
Keyword(s):  
Health Care ◽  
At Risk ◽  
Patient Safety ◽  
Quality Of Care ◽  
Code Of Ethics ◽  
Codes Of Ethics ◽  
Lessons Learned ◽  
Professional Conduct ◽  
Australian Health

IN NOVEMBER 2002, in what stands as one of the most significant whistle blowing cases in the history of the Australian health care system, four nurses went public with concerns they had about the management of clinical incidents and patient safety at two hospitals in Sydney, New South Wales. The handling of this case and its aftermath raises important moral questions concerning the nature of whistleblowing in health care domains and the possible implications for the patient safety and quality of care movement in Australia. This paper presents an overview of the case, the moral risks associated with whistleblowing, and some lessons learned. The International Council of Nurses (2000) Code of Ethics stipulates that nurses have a stringent responsibility to 'take appropriate action to safeguard individuals when their care is endangered by a co-worker or any other person'. Other local and international nursing codes of ethics and standards of professional conduct likewise obligate nurses to take appropriate action to safeguard individuals when placed at risk by the incompetent, unethical or illegal acts of others ? including the system. Despite these coded moral prescriptions for responsible and accountable professional conduct, taking appropriate action when others are placed at risk (including making reports to appropriate authorities) is never an easy task nor is it free of risk for nurses. As has been amply demonstrated in the literature, taking a moral stance to protect patient safety and quality of care can be extremely hazardous to nurses (Johnstone 1994, 2002, 2004; Ahern & McDonald 2002). In situations where nurses report their concerns to an appropriate authority but nothing is done to either investigate or validate their claims, nurses are faced with the ethical dilemma and 'choice' of whether to: do nothing ('put up and shut up'); leave their current place of employment (and possibly even the profession); or take the matter further ('blow the whistle') by reporting their concerns to an external authority that they perceive as having the power to do something about their concerns. It is rare for nurses to 'blow the whistle' in the public domain. When they do, it is usually because they perceive that something is terribly wrong and, as a matter of conscience, they cannot just look on as morally passive bystanders. For those nurses who do take a stand, the costs to them personally and professionally are almost always devastating, with no guarantees that the situation on which they have taken a public stance will be improved. Nurses who blow the whistle often end up with their careers and lives in tatters (see case studies in Johnstone 1994 & 2004).

scholarly journals Slaves to economists? A Canadian's view of the Australian health care system

2005 ◽  
Vol 29 (4) ◽  
pp. 386 ◽  
Author(s):  
Raisa B Deber
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Lessons Learned ◽  
The Public ◽  
Australian Health ◽  
Care Services ◽  
Intellectual Influence ◽  
Necessary And Sufficient ◽  
Public Private Mix ◽  
Cross National

AN EXPERT IS DEFINED as someone from out of town ? with slides. In health care, such experts also have a tendency to make cross-national comparisons on the basis of a short visit, a few conversations, and a desire to indicate ?lessons learned?.1 In that time-honoured tradition, on the basis of a visit to Melbourne to address the Victorian Healthcare Association, coupled with visits to several local hospitals, this Canadian identified several potential problems arising from Australia?s approach to the public?private mix of hospital services. As Keynes noted, ?The ideas of economists and political philosophers, both when they are right and when they are wrong, are more powerful than is commonly understood. Indeed the world is ruled by little else. Practical men, who believe themselves to be quite exempt from any intellectual influence, are usually the slaves of some defunct economist.?2 Over the past decades, many health care reformers have urged change ? with varying degrees of success ? based on a set of ideas that markets are always right, that competition is both necessary and sufficient for efficiency, and that private is superior to public. One consequence has been a push for a greater role for private delivery of health care services. This is currently hotly contested in Canada, with Australia providing either an exemplary example or a cautionary tale, depending upon ideological proclivities. I was therefore interested in learning more from Australians as to areas of success or failure of the public?private mix in Australia, and this paper highlights my observations.

Medical Informatics and the Quality of Health: New Approaches to Support Patient Care

2003 ◽  
Vol 42 (02) ◽  
pp. 185-189 ◽  
Author(s):  
R. Haux ◽  
C. Kulikowski ◽  
A. Bohne ◽  
R. Brandner ◽  
B. Brigl ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Informatics ◽  
Health Care Providers ◽  
Medical Knowledge ◽  
Lessons Learned ◽  
Care Providers ◽  
Access To Health Services ◽  
Leading Role ◽  
Future Challenges

Summary Objectives: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of excellent papers on medical informatics research which have been recently published (www.yearbook.uni-hd.de). The 2003 Yearbook of Medical Informatics took as its theme the role of medical informatics for the quality of health care. In this paper, we will discuss challenges for health care, and the lessons learned from editing IMIA Yearbook 2003. Results and Conclusions: Modern information processing methodology and information and communication technology have strongly influenced our societies and health care. As a consequence of this, medical informatics as a discipline has taken a leading role in the further development of health care. This involves developing information systems that enhance opportunities for global access to health services and medical knowledge. Informatics methodology and technology will facilitate high quality of care in aging societies, and will decrease the possibilities of health care errors. It will also enable the dissemination of the latest medical and health information on the web to consumers and health care providers alike. The selected papers of the IMIA Yearbook 2003 present clear examples and future challenges, and they highlight how various sub-disciplines of medical informatics can contribute to this.

Benefits, Challenges, and Social Impact of Health Care Providers’ Adoption of Social Media

2021 ◽  
pp. 089443932110257
Author(s):  
Md Irfanuzzaman Khan ◽  
Jennifer (M.I.) Loh
Keyword(s):  
Health Care ◽  
Social Media ◽  
Health Promotion ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Community Support ◽  
Care Providers ◽  
Australian Health ◽  
Actual Use ◽  
Use Of Social Media

With the advent of telecommunication technologies and social media, many health care professionals are using social media to communicate with their patients and to promote health. However, the literature reveals a lacuna in our understanding of health care professionals’ perception of their behavioral intentions to use innovations. Using the Unified Technology Acceptance Framework (unified theory of acceptance and use of technology), in-depth interviews were conducted with 16 Australian health care experts to uncover their intent and actual use of social media in their medical practices. Results revealed that social media tools offered five significant benefits such as (i) enhanced communication between health care professionals and their patients, (ii) community support, (iii) enabled e-learning, (iv) enhanced professional network, and (v) expedited health promotion. However, result also revealed barriers to social media usage including (i) inefficiency, (ii) privacy concerns, (iii) poor quality of information, (iv) lack of trust, and (v) blurred professional boundary. Peer influence and supporting conditions were also found to be determinants of social media adoption behaviors among health care professionals. This study has important implications for health care providers, patients, and policy makers on the responsible use of social media, health promotion, and health communication. This research is also among the very few studies that explore Australian health care professionals’ intent and actual use of innovations within a health care setting.

A New Scale of Readiness for Health Care Students to Encounter Partner Abuse

2020 ◽  
pp. 088626052098113
Author(s):  
Simon Sawyer ◽  
Glenn Melvin ◽  
Angela Williams ◽  
Brett Williams
Keyword(s):  
Health Care ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Partner Abuse ◽  
Content Validation ◽  
Post Intervention ◽  
Good Reliability ◽  
Health Care Students ◽  
Australian Health ◽  
Health Care Practitioners

Partner abuse (PA) is associated with significant morbidity and mortality worldwide. Health care practitioners regularly encounter patients experiencing PA and require comprehensive education on how to respond. This study describes the creation and validation of a new measure of readiness to encounter patients experiencing PA for health care practitioners and students. Initial item development and content validation were informed by expert feedback. Psychometric properties were assessed using data collected from Australian health care students, using Principal Components Analysis (PCA) and Confirmatory Factor Analysis (CFA). Internal consistency, inter-scale correlations, and test–retest analysis were performed. An initial pool of 67 items was reduced to 48 following content validation by 5 experts as a measure of construct validity. A total of n = 926 responses were collected, which were randomly split into two groups to perform a PCA and CFA. The PCA resulted in a 31-item version, which was further reduced to a 27-item version following the CFA, containing four factors. Internal consistency and test–retest analyses demonstrated good reliability. The produced scale is a 27-item measure of readiness to encounter patients experiencing PA, which has demonstrated good psychometric properties with a sample of Australian health care students. Results indicate that self-efficacy and Emotional-readiness are a large component of readiness. The scale may be used to measure the readiness of a cohort, or as a pre and post-intervention measure, and results may provide insight into the educational needs of a cohort.

Are Communities Willing to Transition Into Learning Health Care Communities? A Community-Based Participatory Evaluation of Stakeholders’ Receptivity

2021 ◽  
pp. 104973232199864
Author(s):  
Nabil Natafgi ◽  
Olayinka Ladeji ◽  
Yoon Duk Hong ◽  
Jacqueline Caldwell ◽  
C. Daniel Mullins
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Lessons Learned ◽  
Community Members ◽  
Community Based ◽  
Care Community ◽  
Care Experience ◽  
National Initiative

This article aims to determine receptivity for advancing the Learning Healthcare System (LHS) model to a novel evidence-based health care delivery framework—Learning Health Care Community (LHCC)—in Baltimore, as a model for a national initiative. Using community-based participatory, qualitative approach, we conducted 16 in-depth interviews and 15 focus groups with 94 participants. Two independent coders thematically analyzed the transcripts. Participants included community members (38%), health care professionals (29%), patients (26%), and other stakeholders (7%). The majority considered LHCC to be a viable model for improving the health care experience, outlining certain parameters for success such as the inclusion of home visits, presentation of research evidence, and incorporation of social determinants and patients’ input. Lessons learned and challenges discussed by participants can help health systems and communities explore the LHCC aspiration to align health care delivery with an engaged, empowered, and informed community.

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