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Indian Health Service facilities made progress incorporating patient protection policies, but challenges remain
Indian Health Service facilities made progress incorporating patient protection policies, but challenges remain
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Report in brief (United States. Department of Health and Human Services. Office of Inspector General)
- Contributor(s):
- United States. Department of Health and Human Services. Office of Inspector General. Office of Evaluation and Inspections, issuing body.
- Publication:
- Washington, D.C. : U.S. Department of Health and Human Services, Office of Inspector General, December 2020
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Child Abuse, Sexual -- prevention & control
Government Regulation
Patient Safety -- legislation & jurisprudence
Policy
Professional Misconduct -- legislation & jurisprudence
United States
United States. Department of Health and Human Services
United States. Indian Health Service - Genre(s):
- Technical Report
- Abstract:
- Why OIG Did This Review. In recent years, the Indian Health Service (IHS) had cases of health care providers abusing patients under facility care. In February 2019, the Deputy Secretary of HHS and the Senate Committee on Indian Affairs both requested that OIG review IHS policies for preventing, reporting, and addressing patient abuse in IHS facilities. An OIG report issued in December 2019 found that IHS had strengthened its policies to protect children from sexual abuse by providers. Yet, we found gaps in IHS policies, such as not covering different types of abuse and circumstances, and found that some IHS facilities had not implemented the new agencywide policies. This study expands on that report, assessing facility implementation of the policies, and identifying potential challenges to their effectiveness. How OIG Did This Review. We based our findings on survey responses from 97 IHS-operated health care facilities, including hospitals, health centers, and health stations, and onsite interviews with leadership and staff at 16 of these facilities. We collected our data during February–March 2020. Topics for the survey and interviews included implementation of IHS patient protection policies and related challenges, training needs, communication and collaboration with IHS headquarters and Area Offices, and barriers to patient abuse reporting and improvement efforts. What OIG Found. Most IHS facilities (81 of 97) reported that they fully incorporated the agencywide patient protection policies, aimed at preventing and addressing child sexual abuse by health care providers, into their local policies and procedures, but some facilities are still early in implementation. All facilities reported that staff completed mandatory training on the new policies. Many facilities supplemented the training and expressed need for further training to support staff understanding of reporting requirements. We found that nearly two-thirds of facilities (62 of 97) reported encountering challenges in carrying out the policies. The most common challenges were providing chaperones during medical exams, due to staffing shortages and delays in background investigations; ensuring anonymity of victims and reporters; coordinating with law enforcement; and understanding the policies. All facilities said that they were generally confident that staff would report suspected patient abuse, but most (88 of 97) noted existing barriers that may deter staff and patients from reporting. We found that IHS has established avenues for reporting patient abuse and taken steps to promote an organizational culture of transparency, but the facilities reported remaining barriers, including fear of retaliation, stigma related to sexual abuse, and lack of awareness on what and how to report, among others. We identified some of the same barriers in our 2019 report.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (37 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918283580306676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918283580306676