Medical misadventure, legislation, reporting, and injury prevention : an evaluation of the process of ACC's reporting of medical error findings with regard to injury prevention : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Social Policy at Massey University

Abstract

This research investigated and evaluated the reporting process with regard to medical error as under the Accident Rehabilitation Compensation Insurance Act (1992) and the impact of that process with regard to the prevention of injury. It considers: (a) whether the legislation is consistent with regard to the aim of the prevention of injury; (b) the outcomes of the reporting process in terms of injury prevention; (c) if anything else could be done in terms of injury prevention. Under the Accident Rehabilitation and Compensation Insurance Act (1992) the Accident Compensation Corporation (ACC) was specifically required to 'report the circumstances [of the injury] to the appropriate body with a view to the institution of disciplinary proceedings, and to any other body that may be appropriate' if the Corporation was satisfied that negligence or inappropriate action had caused personal injury (ARCI Act, 1992). Reporting of medical error by health professionals is one mechanism available to the ACC to prevent injury. Reporting to bodies such as the Health and Disability Commissioner's (HDC) office and organisations responsible for the registering of health professionals can result in changes which minimise the re-occurrence of the medical error. This research is based on a formative policy evaluation. It seeks to improve ACC's medical error reporting process and employs the methodological tools of document research and case studies. The study is based on a random selection of sixty claims accepted on the basis of medical error under the Accident Rehabilitation and Compensation Insurance Act (1992). The process of data analysis was informed by grounded theory in that four analytical categories established were based on similarity of content, according to their injury prevention outcome. The key findings of this evaluation resulted in recommendations which relate to improving the ACC's medical error reporting process. These may be of interest to those working in the area of policy development and/or process improvement, with regard to the reporting of medical error for the purpose of injury prevention. It is clear that there is a need for further research into the outcome of injury prevention initiatives undertaken by professional bodies and for the uptake of injury prevention initiatives by the ACC and the HDC's office.