NIVEL, P.O. Box 1568, 3500 BN Utrecht, The Netherlands.
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. box 1738, 3000 DR Rotterdam, The Netherlands.
Int J Environ Res Public Health. 2018 May 29;15(6):1104. doi: 10.3390/ijerph15061104.
Involving patients and families in mental healthcare is becoming more commonplace, but little is known about how they are involved in the aftermath of serious adverse events related to quality of care (sentinel events, including suicides). This study explores the role patients and families have in formal processes after sentinel events in Dutch mental healthcare. We analyzed the existing policies of 15 healthcare organizations and spoke with 35 stakeholders including patients, families, their counselors, the national regulator, and professionals. Respondents argue that involving patients and families is valuable to help deal with the event emotionally, provide additional information, and prevent escalation. Results indicate that involving patients and families is only described in sentinel event policies to a limited extent. In practice, involvement consists mostly of providing aftercare and sharing information about the event by providers. Complexities such as privacy concerns and involuntary admissions are said to hinder involvement. Respondents also emphasize that involvement should not be obligatory and stress the need for patients and families to be involved throughout the process of treatment. There is no one-size-fits-all strategy for involving patients and families after sentinel events. The first step seems to be early involvement during treatment process itself.
让患者和家属参与精神卫生保健变得越来越普遍，但对于他们在与医疗质量相关的严重不良事件（警戒事件，包括自杀）发生后的参与程度，人们知之甚少。本研究探讨了患者和家属在荷兰精神卫生保健中警戒事件后的正式流程中所扮演的角色。我们分析了 15 家医疗机构的现有政策，并与包括患者、家属、他们的顾问、国家监管机构和专业人员在内的 35 名利益相关者进行了交谈。受访者认为，让患者和家属参与进来，有助于在情感上处理事件，提供额外的信息，并防止事件升级。研究结果表明，在警戒事件政策中，仅有限地描述了让患者和家属参与进来。在实践中，参与主要包括由提供者提供善后护理和分享有关事件的信息。一些复杂因素，如隐私问题和非自愿入院，被认为会阻碍参与。受访者还强调，参与不应该是强制性的，并强调需要让患者和家属在整个治疗过程中参与进来。对于警戒事件发生后如何让患者和家属参与进来，没有一种放之四海而皆准的策略。第一步似乎是在治疗过程中尽早让他们参与进来。
