PDF(Pubmed)
Abstract：
Protection of the public is the paramount aim for health practitioner regulation, yet there has been growing concern globally on the association between regulatory complaints processes and practitioner mental health and wellbeing. The objective was to understand the experience, particularly distress, of health practitioners involved in a regulatory complaints process to identify potential strategies to minimise future risk of distress. Semi-structured qualitative interviews were conducted with health practitioners in Australia who had recently been through a regulatory complaints process, together with a retrospective analysis of documentation relating to all identified cases of self-harm or suicide of health practitioners who were involved in such a process over 4 years. Data from interviews and the serious incident analysis found there were elements of the regulatory complaints process contributing to practitioner distress. These included poor communication, extended time to close the investigation, and the management of health-related concerns. The study found external personal circumstances and pre-existing conditions could put the practitioner at greater risk of distress. There were found to be key moments in the process-triggers-where the practitioner was at particular risk of severe distress. Strong support networks, both personal and professional, were found to be protective against distress. Through process improvements and, where appropriate, additional support for practitioners, we hope to further minimise the risk of practitioner distress and harm when involved in a regulatory complaints process. The findings also point to the need for improved partnerships between regulators and key stakeholders, such as legal defence organisations, indemnity providers, employers, and those with lived experience of complaints processes. Together they can improve the support for practitioners facing a complaint and address the stigma, shame, and fear associated with regulatory complaints processes. This project provides further evidence that a more compassionate approach to regulation has the potential to be better for all parties and, ultimately, the wider healthcare system.
摘要：
背景：保护公众是卫生从业者监管的首要目标，然而，全球越来越关注监管投诉流程与从业者心理健康和福祉之间的关联。目的是了解经验，尤其是痛苦，参与监管投诉过程的卫生从业人员，以确定潜在的策略，以最大程度地减少未来的痛苦风险。
方法：对最近经历过监管投诉过程的澳大利亚卫生从业人员进行了半结构化定性访谈，以及对参与此类过程四年的所有已确定的卫生从业人员自残或自杀案件的相关文件进行回顾性分析。
结果：来自访谈和严重事件分析的数据发现，监管投诉过程中存在导致从业者痛苦的因素。其中包括沟通不畅，延长了结束调查的时间，以及健康相关问题的管理。研究发现，外部个人情况和预先存在的条件可能会使从业者面临更大的痛苦风险。在这个过程中发现了关键时刻——触发因素——从业者特别有遭受严重痛苦的风险。强大的支持网络，个人和专业，被发现对痛苦有保护作用。
结论：通过流程改进和，在适当的情况下，对从业者的额外支持，我们希望在参与监管投诉过程时，进一步尽量减少执业者痛苦和伤害的风险。调查结果还指出，监管机构和主要利益相关者之间需要改善伙伴关系，例如法律辩护组织，赔偿提供者，雇主,以及那些有投诉过程经验的人。他们一起可以改善对面临投诉的从业者的支持，并解决耻辱，与监管投诉过程相关的羞耻和恐惧。该项目提供了进一步的证据，表明更富有同情心的监管方法有可能对所有各方都更好，最终,更广泛的医疗保健系统。
方法：对最近经历过监管投诉过程的澳大利亚卫生从业人员进行了半结构化定性访谈，以及对参与此类过程四年的所有已确定的卫生从业人员自残或自杀案件的相关文件进行回顾性分析。
结果：来自访谈和严重事件分析的数据发现，监管投诉过程中存在导致从业者痛苦的因素。其中包括沟通不畅，延长了结束调查的时间，以及健康相关问题的管理。研究发现，外部个人情况和预先存在的条件可能会使从业者面临更大的痛苦风险。在这个过程中发现了关键时刻——触发因素——从业者特别有遭受严重痛苦的风险。强大的支持网络，个人和专业，被发现对痛苦有保护作用。
结论：通过流程改进和，在适当的情况下，对从业者的额外支持，我们希望在参与监管投诉过程时，进一步尽量减少执业者痛苦和伤害的风险。调查结果还指出，监管机构和主要利益相关者之间需要改善伙伴关系，例如法律辩护组织，赔偿提供者，雇主,以及那些有投诉过程经验的人。他们一起可以改善对面临投诉的从业者的支持，并解决耻辱，与监管投诉过程相关的羞耻和恐惧。该项目提供了进一步的证据，表明更富有同情心的监管方法有可能对所有各方都更好，最终,更广泛的医疗保健系统。
