Health – Video focuses on healing and learning from health care harm

A new film, Pou hihiri, Pou o te aroha | Healing and learning from harm, features consumers, clinicians and researchers talking about the benefits of following a restorative approach after a harmful event occurs in health care. Restorative practice and hohou te rongopai (peace-making from a te ao Māori world view) are described – both provide a response that recognises people are hurt and their relationships affected.

A restorative approach is where those affected by a harmful event come together in a safe and supportive environment to talk openly about what happened and the impact it has had on their lives, and to clarify the responsibility for the actions, for healing and learning.

The focus is on participation, respectful listening and communication, truthfulness, accountability, empowerment and equal concern.

Jo Wailling, research fellow at the Diana Unwin Chair in Restorative Justice, says current investigative approaches to harm are well intentioned but are characterised by letter-writing and written documents, and generally there’s somebody who decides if a harmful event has occurred.

‘In the aftermath of harm and through the processes that follow – disclosure, investigation, resolution and change – the experience of harm can be compounded,’ she says.

Graham Bidois Cameron, Pou Tikanga at Bay of Plenty District Health Board, says the current approach does not work for Māori.

‘We need to understand that our system is perceived as a threat to whānau Māori, so when Māori are coming into the system, they’re not starting in a place of trust. The system works when people believe it’s going to work for them; Māori don’t believe this.

‘Māori respond to a relational approach, rather than the risk approach we see currently. A hohou te rongopai approach is about the restoration of mana and wellbeing, through whanaungatanga. It connects people and provides a pathway for resolving complaints and adverse events, consistent with a Māori understanding of wellbeing.’

Charlotte Korte from Mesh Down Under – a consumer advocacy group that supports New Zealanders harmed by surgical mesh – says the restorative approach to surgical mesh harm led by the Ministry of Health lets everyone share their views.

‘The difference between reading a report and sitting down with a patient, their families or whānau and hearing their story is huge. The surgical mesh issue unearthed a whole lot of trauma and damage. We had been raising concerns for years and banging our heads against a brick wall, and it felt like nobody was listening.

‘Even though I was sceptical about the restorative process to start with, I think it was the right move because you can’t keep doing the same thing and expecting something to change. There needs to be a clear indication of what action is going to be taken, whether it’s going to be evaluated, and that it’s meaningful and prevents further harm,’ she says.

Dr Andrew Simpson, former chief medical officer at the Ministry of Health, says a restorative approach provides a format where clinicians really listen and understand each person’s story of harm.

‘This is a mechanism for people to express their feelings and the impact of the harm that has happened to them. It’s not personally directed.

‘You can’t put your own take on the event until you’ve heard everything, and that can take you in a different direction than if you’d reacted to only part of the story. Something in the system may not be working; how do we turn that around, how do we learn from what happened to ensure it doesn’t happen to others?’

Background

Pou hihiri, Pou o te aroha | Healing and learning from harm was developed by the Diana Unwin Chair in Restorative Justice and Stella Maris productions in consultation with several health sector and Māori partners, and funded by the Health Quality & Safety Commission, ACC and the Diana Unwin Chair.

The Health Quality & Safety Commission recognises there is an opportunity to improve how we approach harm that has occurred in the health and disability sector, to find resolution in a manner that respects the values and wishes of all people. At times our best efforts to understand what happened during an event of harm have led to more harm through things such as delays, language and processes used. We have seen that resolution can occur for all people through the use of restorative practice and hohou te rongopai, and encourage the sector to consider these approaches in the future. 

The Diana Unwin Chair in Restorative Justice was established in January 2014. The chair serves as the focus for collaborative, interdisciplinary research and teaching on restorative justice theory and practice, both within the justice sector and beyond.