Principles for engaging consumers and whānau in mental health and addiction adverse event reviews

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This information is provided for mental health and addiction (MHA) services. It is intended to guide adverse event [1]  review facilitators on the principles of engaging with consumers and their whānau [2] affected by an adverse event and to complement the Te Tāhū Hauora Health Quality & Safety Commission resource How to engage with consumers and whānau following an adverse event. [3]

Cultural needs

• Ensure psychological safety [4] for all involved in the adverse event review process.
• Seek cultural advice and support throughout the review process. 
• Be led by the principles of whakawhanaungatanga [5] and kotahitanga. [6]
• Ensure everyone understands the purpose of each part of the process.
• Be clear about the parameters and limitations of the process.
• Clarify the expectations of those involved in the process.
• Follow tikanga [7] practices. 
• Have processes in place to support staff resilience so staff can respond when and where needed after an adverse event.
• Encourage staff to demonstrate flexibility and adaptability when working with consumers and whānau, both during and after a serious event review.
• Be compassionate – listen to understand. 

Consumer

• Keep stories of the consumer experience at the heart of your work.
• Provide training in the adverse event review process to your consumer leaders, consumer advisors and whānau advisors.
• Understand and work to address the power dynamics that exist in health systems and between consumer and clinical roles.
• When involving consumers (both the consumer, staff and/or those affected by the adverse event) be clear what you are asking people to do. Clarify roles, responsibilities and expectations – from both perspectives.
• Offer coaching and mentoring to consumers involved in the review process/team, especially if they are at the early stage in their experience of adverse event reviews. 

Whānau

• Timelines for reviews are to be developed in consultation with the affected whānau.
• Aim to complete everything that happens in partnership with the affected whānau.
• Appoint a 'connector' from your team, who stays involved and provides ongoing information on the process (eg, whānau liaison).
• Ask whānau if they want to nominate a spokesperson to stay connected, if the whānau themselves are not ready to be involved.
• Be clear that you are speaking to the nominated spokesperson – as designated by the whānau.
• Ask whānau what their preferences are for cultural and other support required.
• Whānau are unique – respect and honour this.
• Establish a centralised log of all whānau contacts: by who, when, actions and next steps. Summarise outcomes.
• Meet with whānau at places and times that are convenient and safe for them.

Published in June 2023 by Te Tāhū Hauora Health Quality & Safety Commission, PO Box 25496, Wellington 6146, New Zealand. Available online at www.hqsc.govt.nz.

References

1. An adverse event is ‘an event in which a person receiving health care experienced harm’. Harm is ‘negative consequences for consumers and whānau directly arising from or associated with plans made, actions taken or omissions during the provision of health care rather than an underlying disease or injury’. Te Tāhū Hauora Health Quality & Safety Commission. 2023. Healing, learning and improving from harm: National adverse events policy 2023 | Te whakaora, te ako me te whakapai ake i te kino: Te kaupapa here ā-motu mō ngā mahi tūkino 2023. Wellington: Te Tāhū Hauora. URL: www.hqsc.govt.nz/resources/resource-library/national-adverse-event-policy-2023.
2. Whānau is the family, extended family or family group of people who are important to a person who is receiving a service. Whānau includes a person’s extended family, their partners, friends, guardians or other representatives chosen by the person. Ibid.
3. www.hqsc.govt.nz/our-work/system-safety/adverse-events/education/how-to-engage-with-consumers-following-an-adverse-event
4. Psychological safety – a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns or mistakes. Edmondson A. 2018. The Fearless Organization: Creating psychological safety in the workplace for learning, innovation, and growth. New Jersey: John Wiley & Sons.
5. Whakawhanaungatanga – process of establishing relationships, relating well to others (https://maoridictionary.co.nz).
6. Kotahitanga – unity, togetherness, solidarity, collective action (https://maoridictionary.co.nz).
7. Tikanga – … the customary system of values and practices that have developed over time and are deeply embedded in the social context (https://maoridictionary.co.nz).