Humanizing harm: Using a restorative approach to heal and learn from adverse events

Area of Science:

• Patient safety
• Healthcare policy
• Restorative justice

Background:

• Healthcare remains risky, with 10% of hospital patients experiencing adverse events despite policy efforts.
• Current investigative responses often overlook human impacts, exacerbating harm.
• Existing approaches fail to adequately address the needs of patients, families, and healthcare professionals.

Purpose of the Study:

• To explore how investigative responses can compound harm in healthcare.
• To propose a restorative approach to mitigate compounded harm.
• To advocate for a shift towards relational and regulatory frameworks in incident investigations.

Main Methods:

• Analysis of current healthcare investigative practices and their impact.
• Conceptualization of a restorative approach to incident response.
• Incorporation of findings from New Zealand's restorative response to surgical mesh harm.

Main Results:

• Current investigations can compound harm by neglecting human impacts.
• A restorative approach, integrating healing and system learning, can reduce compounded harm.
• Restorative approaches have the potential to transform investigative processes and outcomes.

Conclusions:

• Healthcare incident responses require a shift from purely regulatory to relational frameworks.
• Implementing restorative principles can improve outcomes for patients, families, and healthcare professionals.
• Further research is needed to identify preconditions for successful restorative approaches in global health systems.