involving people in regulation

Paul Robben, 02-04-2012

Content • Policy plan IGZ• Practice of involving people in supervision• The agenda for the near future• Incident supervision

Policy plan 2012-2015• Why an inspectorate?

To uphold and to promote compliance with (useful) laws and regulationsTo secure public values

• The population must benefitThe citizen is the “client”Citizens can have (justified) confidence in good care Citizens perspective in regulations enforce the legitimacy of the inspectorateEffective regulation

Core business of inspectorate of health care• Promoting and enforcing compliance with, laws, regulations and

professional standards in health care with regard to safety and quality is the core business of the IGZ

• Regulation is an important part of keeping confidence in the public system

• This is what citizens expect and why they are prepared to pay for the inspectorate with their money (tax money)

Practice No structural involvement of citizens in regulation

Involvement: • thematic supervision• Meeting patients in nursing homes and mental healthcare

facilities • Regulair managerial consultation of patient associations

The agenda for the near future • Supervision if care is patient focused • Using information from people • Communication with the public • Consultation of patients and citizens

Care should be patient focused Legislation

• Is care patient oriented? • Is patient participation organized? • Does the complain system function well?

Using information from people • Complaints (IGZ doesn't handle complaints)• Lay inspectors (experts by experience)??? • Mystery guests???????????????????• Social media

• How to weigh and analyse this information • Meeting patients during inspections

• Listen to their voice

Communication with citizens

• Reports that are accessible and written for the public • Social media• Active media strategy

Consultation• Patient advisory groups /patient panels

• What are the risks for the patients and the public, setting priorities

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Incident supervision • 8000 notifications of incidents

• 1400 by patients• 6600 by healthcare organisations and professionals

• laws state that incidents, severe failures, events and changes must be notified to the IGZ.

• Patients are invited to submit a complaint about the care. We like to share their experiences.

• Complaints are legally handled by complain-commissions at the institutes

• All the information received is taken into account to pass judgement on whether the government standards are being met

1400 notifications/complaints from civiliansWhat do they complain about?• not being taken seriously• not being well informed• sexual harassment • severe errors while receiving medical treatment

Why do they complain?• it’s all about trust! • prevention from the same mistake being made twice• not for revenge nor satisfaction nor restitution

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What do we do with the 1400 complaints?• we asses the complain along the criteria given in the IGZ guiding principle (Leidraad Meldingen)

• when it is a ‘personal problem’, the complainant is directed to complaint committee of the health care provider

• in case of structural problems, the complaint is used as the starting point of the investigation by IGZ

• these investigations can be carried out by the health care provider as an audit. Results and actions taken have to be judged by IGZ. The investigation can also be carried out by IGZ in complex /urgent/ severe cases or media and political attention

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What does the complainer expect • to be taken seriously • to be given the chance to tell their side of the story• to receive information about the way our health care system, the various laws and acts work• to be given a helping hand in submitting a formal complaint with the complaint committee • to be told what their rights and obligations are

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Is complaining with us the most effective solution to their problems?

• we have to earn their trust where they lost theirs in the system / the health care institute/ provider • problems should be solved where the problems are caused• intervention from IGZ is on structural level• expectations of complainers have to be managed: we cannot interfere directly as we are, by law, no complaint committee• our way of handling the complaint is easily perceived as taking sides with the health care professional •The way we handle complains of patients makes the IGZ vulnerable

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