Towards a multilevel governance framework on the implementation of patient rights in health facilities: a protocol for a systematic scoping review

Putturaj, Meena; Belle, Sara Van; Criel, Bart; Engel, Nora; Krumeich, Anja; Nagendrappa, Prakash B.; Prashanth, N S

doi:10.1136/bmjopen-2020-038927

Cited by 9 publications

(16 citation statements)

References 34 publications

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“…rules in practice to implement patient rights). Our initial conceptual framework (Putturaj et al, 2020) is grounded in the literature on patient rights, public policy implementation and multilevel governance to guide the evidence synthesis on grievance redressal. This initial framework was refined based on the review we undertook, as described below.…”

Section: Theoretical Lens Appliedmentioning

confidence: 99%

“…We used NVivo V.12 software for coding the data. To iterate between the previously published theoretical framework (Putturaj et al, 2020) and the data emerging from the review, we adopted both inductive and deductive approaches. The authors discussed and resolved any discordant views on data collection and analysis.…”

Section: Search Strategymentioning

confidence: 99%

“…We used only court cases from SCI, so for further understanding of the governance of patient rights protection, exploratory research in this domain from other LMICs is required. Other limitations are detailed in the published protocol of this review (Putturaj et al, 2020). The literature also seemed to be increasingly focussed on medical professionals in the grievance redressal systems, thus limiting understanding of the grievance redressal processes adopted for allied health professionals such as nurses, lab technicians and physiotherapists.…”

Section: Interplay Among Actors In the Grievance Redressal Systemsmentioning

confidence: 99%

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Multilevel governance framework on grievance redressal for patient rights violations in India

Putturaj

Belle

Engel

et al. 2021

Health Policy and Planning

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The notion of patient rights encompasses the obligations of the state and healthcare providers to respect the dignity, autonomy and equality of care-seeking individuals in healthcare processes. Functional patient grievance redressal systems are key to ensuring that the rights of individuals seeking healthcare are protected. We critically examined the published literature from high-income and upper-middle-income countries to establish an analytical framework on grievance redressal for patient rights violations in health facilities. We then used lawsuits on patient rights violations from the Supreme Court of India to analyse the relevance of the developed framework to the Indian context. With market perspectives pervading the health sector, there is an increasing trend of adopting a consumerist approach to protecting patient rights. In this line, avenues for grievance redressal for patient rights violations are gaining traction. Some of the methods and instruments for patient rights implementation include charters, ombudsmen, tribunals, health professional councils, separating rules for redressal and professional liability in patient rights violations, blame-free reporting systems, direct community monitoring and the court system. The grievance redressal mechanisms for patient rights violations in health facilities showcase multilevel governance arrangements with overlapping decision-making units at the national and subnational levels. The privileged position of medical professionals in multilevel governance arrangements for grievance redressal puts care-seeking individuals at a disadvantaged position during dispute resolution processes. Inclusion of external structures in health services and the healthcare profession and laypersons in the grievance redressal processes is heavily contested. Normatively speaking, a patient grievance redressal system should be accessible, impartial and independent in its function, possess the required competence, have adequate authority, seek continuous quality improvement, offer feedback to the health system and be comprehensive and integrated within the larger healthcare regulatory architecture.

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Section: Theoretical Lens Appliedmentioning

confidence: 99%

Section: Search Strategymentioning

confidence: 99%

Section: Interplay Among Actors In the Grievance Redressal Systemsmentioning

confidence: 99%

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Multilevel governance framework on grievance redressal for patient rights violations in India

Putturaj

Belle

Engel

et al. 2021

Health Policy and Planning

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“…In light of the need of patients to be aware of their rights, health institutes must learn about information-seeking behavior and possible information channels and how to convey patient rights effectively. Furthermore, research on patient rights is relatively scant [15,16]. The juxtaposition of patients' awareness of their rights with credibility as a main construct and limited health communication research accentuates the importance of the current study.…”

Section: Introductionmentioning

confidence: 98%

The Mediated Role of Credibility on Information Sources and Patient Awareness toward Patient Rights

Roth‐Cohen

Levy

Zigdon

2021

IJERPH

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Although patient rights are an important issue, this remains an understudied research area. Patients are unaware of their rights, lacking control of health care treatments they might deserve. This can contribute to sustaining inequality as well as failure in achieving welfare policy goals. Drawing on channel complementarity theory, the current study explored patients’ awareness toward their rights, and the credibility of information sources related to patient rights. In a web-based survey, 994 Israeli participants, suffering from chronic illness and using health services, were recruited. To examine the study’s theoretical framework and relationships among the constructs and test the hypotheses, a path analysis was conducted using Structural Equation Modeling. The research model depicts direct and indirect relationships between constructs, and the relevant coefficients. The results show a direct and positive interaction between information credibility and patient rights awareness (β = 0.10, p = 0.019). Information credibility partially mediates the relationship between public service information sources and patient rights awareness (bootstrap with 95% CI: 0.01–0.07; p = 0.015). The mass media information sources construct is directly and positively related to information credibility (β = 0.36, p = 0.000). Age was found as a moderator, indicating that information credibility is a factor only at lower ages. Therefore, patient rights should be systematically and reliably accessible in order to raise the awareness and trust of chronic patients regarding information about patient rights. Using planned health communication campaigns mainly via public service sources that are perceived as trustworthy can help contribute to approach patients more effectively and provide them with accessible and detailed information about their rights.

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“…3–5 In this regard, several countries have developed institutional arrangements intended to receive, examine and resolve the complaints raised by individuals about their healthcare encounters. 6 Care-seeking individuals can raise grievances concerning technical aspects of care (eg, clinical care provided) or non-technical aspects of care (eg, staff-patient relationships and management-related issues). Few qualitative studies found that exorbitant costs, lack of time to raise and follow-up the complaints, lack of or inadequate practical and emotional support to pursue complaints, inadequate financial resources deter care-seeking individuals from availing grievance redressal services.…”

Section: Introductionmentioning

confidence: 99%

Crying baby gets the milk? The governmentality of grievance redressal for patient rights violations in Karnataka, India

et al. 2022

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BackgroundPatient rights aim to protect the dignity of healthcare-seeking individuals. Realisation of these rights is predicated on effective grievance redressal for the victims of patient rights violations.MethodsWe used a critical case (that yields the most information) of patient rights violations reported in Karnataka state (South India) to explore the power dynamics involved in resolving grievances raised by healthcare-seeking individuals. Using interviews, media reports and other documents pertaining to the case, we explored the ‘governmentality’ of grievance redressal for patient rights violations, that is, the interaction of micropractices and techniques of power employed by actors to govern the processes and outcomes. We also examined whether existing governmentality ensured procedural and substantive justice to care-seeking individuals.ResultsCollective action was necessary by the aggrieved women in terms of protests, media engagement, petitions and follow-up to ensure that the State accepted a complaint against a medical professional. Each institution, and especially the medical professional council, exercised its power by problematising the grievance in its own way which was distinct from the problematisation of the grievance by the collective. The State bureaucracy enacted its power by creating a maze of organisational units and by fragmenting the grievance redressal across various bureaucratic units.ConclusionThere is a need for measures guaranteeing accountability, transparency, promptness, fairness, credibility and trustworthiness in the patient grievance redressal system. Governmentality as a framework enabled to study how subjects (care-seeking individuals) are rendered governable and resist dominant forces in the grievance redressal system for patient rights violations.

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Towards a multilevel governance framework on the implementation of patient rights in health facilities: a protocol for a systematic scoping review

Cited by 9 publications

References 34 publications

Multilevel governance framework on grievance redressal for patient rights violations in India

Multilevel governance framework on grievance redressal for patient rights violations in India

The Mediated Role of Credibility on Information Sources and Patient Awareness toward Patient Rights

Crying baby gets the milk? The governmentality of grievance redressal for patient rights violations in Karnataka, India

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