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This study aimed to explore the experiences and support requirements of psychiatrists undergoing investigations within their mental health organisation. An anonymous online survey was distributed to all non-training psychiatrists registered as members of the Royal College of Psychiatrists.
Results
Of the 815 psychiatrists who responded to the survey, 287 (35%) had been investigated. The majority (76%) were unaware of the concerns before being notified, 36% lacked understanding and 62% experienced timeline deviations. Furthermore, 34% had concerns over conflicts of interest, with 52% perceiving the investigation as unfair, 62% were not informed of their rights. Many respondents reported feeling isolated and lacking support and experienced significant psychological distress, such as symptoms of post-traumatic stress disorder. Suggestions for improvement included better communication, transparency, impartiality, adherence to timelines, proactive support and oversight, and opportunities for learning and reparation post-investigation.
Clinical implications
Mental health service providers should recognise the multifaceted nature of complaints and provide comprehensive support and guidance to psychiatrists undergoing investigations.
This article explores how complaint investigations undertaken by health ombudsman contribute to the improvement of the healthcare system. Using a qualitative case-study approach, semi-structured interviews were conducted with participants form the Scottish Public Services Ombudsman (SPSO) and three health boards within its jurisdiction. Health board participants were frustrated by complaints process used by the SPSO, in particular the lack of communication during an SPSO investigation especially when there were differences in clinical judgment. Using Braithwaite’s typologies of motivational postures and Hertogh’s models of administrative control it was found that a sense of capitulation was the primary determinant in ensuring health board compliance with SPSO recommendations and that the relationship between SPSO and health boards was predominantly coercive in nature. For the SPSO to be more effective in contributing to system improvement requires it to review its role and means of conducting complaint investigations.
This article presents an empirical study of six grievance mechanisms in multi-stakeholder initiatives (MSIs). It argues that key characteristics of each grievance mechanism as well as the contexts in which they operate significantly affect human rights outcomes. However, even the most successful mechanisms only manage to produce remedies in particular types of cases and contexts. The research also finds that it is prohibitively difficult to determine whether ‘effective’ remedy has been achieved in individual cases. Furthermore, the key intervention by the UN Guiding Principles on Business and Human Rights (UNGPs), to prescribe a set of effectiveness criteria for designing or revising MSI grievance mechanisms, itself appears ineffective in stimulating better outcomes for rights-holders. Drawing on these findings, the article reflects on the future potential and limitations of MSI grievance mechanisms within broader struggles to ensure business respect for human rights.
This chapter considers how the structure and processes of the regulatory systems that govern the legal profession are relevant to lawyers’ ethics and behaviour – that is, the significance of institutions for lawyers’ ethics. In this chapter we consider ways in which the ethics demonstrated by the legal profession as a whole are likely to affect lawyers’ individual and personal ethics. We begin by discussing how our current approaches to regulating the legal profession might, or might not, embody and engender the values that should characterise legal practice. We then focus on the ‘law of lawyering’ – rules and regulatory regimes that have been created to apply specifically to lawyers under the legislation and case law governing the legal professions of each of the States and Territories. The next section provides a brief history of the development of Australian legal professional regulation, before contrasting this with a different regulatory approach that sees market competition as the fairest and most efficient form of professional regulation.
“Patient support” is a concept far broader than the traditional offer of a phone number for a counselor and handing her a pamphlet. It encompasses optimal clinical management, as well as an organizational structure for the whole service to optimize patient experience. We first summarize supporting women over 40 during the COVID pandemic, followed by providing key steps of an individualized clinical management strategy, and the requirements of patient support structures. However, unlike previous publications, this chapter does not end by simply outlining what is desirable. It proceeds to a number of practical steps that fertility services can follow, using the framework of “patient experience architecture” to build suitable structured pathways. Furthermore, it explores the path of digital transformation in an effort to reduce cost and improve consistency delivering core professional values in every interaction. At the end of the chapter there is a short list of useful reading.
This chapter argues that Edmund Spenser is at his most deeply political when he invites his readers to immerse themselves in the lush flowerbeds of his poetry. Immersive reading of the lavish and apparently “pointless” descriptions and inventories of flowers in The Shepheardes Calendar, Virgils Gnat, Muiopotmos, and the Garden of Adonis in The Faerie Queene reveal Spenser at his most resistant to submitting the poetic word to the ideological controls associated with the Crown and the court. Spenser plants his flowerbeds in the morally positive terrain of the liberty of speech and poetic license.
Since their publication in the 1950s and 1980s respectively, the Commentaries on the Geneva Conventions of 1949 and their Additional Protocols of 1977 have become a major reference for the application and interpretation of those treaties. The International Committee of the Red Cross, together with a team of renowned experts, is currently updating these Commentaries in order to document developments and provide up-to-date interpretations of the treaty texts. This article highlights key points of interest covered in the updated Commentary on the Third Geneva Convention. It explains the fundamentals of the Convention: the historical background, the personal scope of application of the Convention and the fundamental protections that apply to all prisoners of war (PoWs). It then looks at the timing under which certain obligations are triggered, those prior to holding PoWs, those triggered by the taking of PoWs and during their captivity, and those at the end of a PoW's captivity. Finally, the article summarizes key substantive protections provided in the Third Convention.
Chapter Two studies how Rome figures in shifting conceptions of the problem of the self. The chapter’semphasis is on sixteenth- and seventeenth-century writers and texts, ranging from Edmund Spenser and John Donne to Sir Thomas Wilson and John Milton. English perspectives on Rome, however, were mediated to a significant extent by continental writers such as Petrarch, Joachim Du Bellay, and Michel Eyquem de Montaigne. Writers trained within (and in Petrarch’s case, actively forging) the traditions of humanist inquiry celebrated their commitment to returning ad fontes. In practice, however, their engagements with a ‘text’ as complex and ramified as Rome risked leaving them endlessly navigating tributary brooks, creeks, streams, and rivers rather than reposing comfortably at the source. The chapter brings together scenes of schooling, staring, and travel in order to study tensions between understandings of the self as being an immured condition of metaphysical finitude, on the one hand, and as being formed via the absorption of capabilities that arrive from the outside, on the other.
Sexual harassment is persistent, prevalent and under-reported in Australian workplaces despite its legal regulation over many decades. The most recent survey data in Australia indicate that the majority of individuals who are subject to sexual harassment at work do not make a formal report or lodge a complaint. The opportunity for voice that organisational processes provide to those who experience sexual harassment at work is a particular focus, given the under-reporting problem. The paper also considers the impact of organisational processes on those who observe the inappropriate behaviour and/or the organisational response. Ultimately, this paper argues that organisations should reduce their reliance on individual complaints by expanding the pathways by which concerns can be raised or observed behaviours addressed that offer alternative voice mechanisms, with an emphasis on problem-solving and early intervention where this is appropriate. The paper also considers different communications strategies, such as approaches to training, the sharing of information about workplace incidents, and leadership on the issue within organisations.
Examines the development of servicemen’s concert parties in the context of the rapid expansion of the fighting forces, and of the significant figures who were key to the provision of music for the purposes of recreation and amusement. This chapter will show that Britain’s armed forces each had a strong tradition of musical entertainments solely by servicemen for their comrades which was much bolstered by men who had been professional performers before they enlisted. Furthermore, this chapter will show that servicemen used the pantomime form to reinforce their belief that they were fighting in a just war.
Sara Meyer, the newly appointed Knowledge Manager at the Legal Ombudsman in Birmingham, describes how they are beginning to set up KM systems to deal with a completely new jurisdiction relating to the hearing of complaints against solicitors. This follows the introduction of reforms contained in the Legal Services Act 2007, which mean that all complaints are now heard by this one organisation.
In the aftermath of Hurricane Katrina, widespread flooding devastated the New Orleans healthcare system. Prior studies of post-hurri-cane healthcare do not consistently offer evidence-based recommendations for re-establishing patient care post-disaster. The primary objective of this study is to examine associations between patient characteristics, chief com-plaints, final diagnoses, and medications prescribed at a post-Katrina clinic to better inform strategic planning for post-disaster healthcare delivery (e.g., charitable donations of medications and medical supplies).
Methods:
This study is a retrospective chart review of 465 patient visits from 02 September 2005 to 22 October 2005 at a post-Katrina clinic in New Orleans, Louisiana that was open for seven weeks, providing urgent care services in the central business district. Using logistic regression, the relationships between patient characteristics (date of visit, gender, age, evacuation status), type of chief complaint, final diagnosis, and type of medication prescribed was examined.
Results:
Of 465 patients, 49.2% were middle-aged, 62.4% were men, 35% were relief workers, and 33.3% were evacuees; 35% of visits occurred in week five. Of 580 chief complaints, 71% were illnesses, 21% were medication refill requests, and 8.5% were injuries. Among 410 illness complaints, 25% were ears, nose, and throat (ENT)/dental, 17% were dermatologic, and 11% were cardiovascular. Most requested classes of medication refills for chronic medical conditions (n = 121) were cardiovascular (52%) and endocrine (24%).Most illness-related diagnoses (n = 400) were ENT/dental (18.2%), dermatologic (14.8%), cardiovascular (10.2%), and pul-monary (10.2%). Thirty-six percent of these diagnoses were infectious. Among 667 medications prescribed, 21% were cardiac agents, 13% pulmonary, 13% neurologic/musculoskeletal/pain, 11% antibiotics, 10% endocrine, and 9.3% anti-allergy. The likelihood of certain chief complaints, diagnoses, and medica-tions prescribed varied with patient characteristics.
Conclusions:
Donations of certain classes of medications were more useful than others. Prevalence of select co-morbidities, the nature of patient involve-ment in recovery activities in the disaster area, and post-disaster health haz-ards may explain variations in chief complaints, diagnoses, and medications prescribed by patient characteristics.
This article examines complaint sequences that terminate
with one party's walking out, unilaterally, on the other.
The analysis of three such extended sequences, using the
Conversation Analytic approach, reveals interactional parallels
among them. The complaints that precede the walkouts are
constructed so as to identify deleterious and generic personal
deficiencies. As these sequences develop, they come to focus
on faults in the current behavior of those involved. In their
final stages, the actions of the leavers appear sensitive to
the persistence of behavior that has been deemed to be at fault.
This combination of features seems connected to both the unilateral
departure and the state of indignation that also becomes evidently
present. This invites comparison with other forms of antagonistic
dispute, such as those that lead to certain instances of murder.
The referendum of 30 August 1999 constituted a historic exercise of the right to self-determination by the people of East Timor. It rejected autonomy within Indonesia and chose to go forward on the path towards independence. Proponents of autonomy complained that they had been barred from participating in the process, and that Timorese staff had systematically told or forced people to vote for independence. However, there is no evidence that the referendum was corrupted through systematic bias on the part of local staff members. The outcome of the referendum, 78.5% in favour of independence, must be accepted as an accurate reflection of the will of the people of East Timor.
To determine the type and frequency of immediate unsolicited feedback received by emergency medical service (EMS) providers from patients or their family members and emergency department (ED) personnel.
Methods:
Prospective, observational study of 69 emergency medical services providers in an urban emergency medical service system and 12 metropolitan emergency departments. Feedback was rated by two medical student observers using a prospectively devised original scale.
Results:
In 295 encounters with patients or family, feedback was rated as follows: 1) none in 224 (76%); 2) positive in 51 (17%); 3) negative in 19 (6%); and 4) mixed in one (<1%). Feedback from 254 encounters with emergency department personnel was rated as: 1) none in 185 (73%); 2) positive in 46 (18%); 3) negative in 21 (8%); and 4) mixed in 2 (1%). Patients who had consumed alcohol were more likely to give negative feedback than were patients who had not consumed alcohol. Feedback from emergency department personnel occurred more often when the emergency medical service provider considered the patient to be critically ill.
Conclusion:
The two groups provided feedback to emergency medical service providers in approximately one quarter of the calls. When feedback was provided, it was positive more than twice as often as it was negative. Emergency physicians should give regular and constructive feedback to emergency medical services providers more often than currently is the case.
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