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Clinical governance breakdown: Australian cases of wilful blindness and whistleblowing

机译：临床治理故障：澳大利亚故意失明和举报的案件

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Background: After their attempts to have patient safety concerns addressed internally were ignored by wilfully blind managers, nurses from Bundaberg Base Hospital and Macarthur Health Service felt compelled to 'blow the whistle'. Wilful blindness is the human desire to prefer ignorance to knowledge; the responsibility to be informed is shirked. Objective: To provide an account of instances of wilful blindness identified in two high-profile cases of nurse whistleblowing in Australia. Research design: Critical case study methodology using Fay's Critical Social Theory to examine, analyse and interpret existing data generated by the Commissions of Inquiry held into Bundaberg Base Hospital and Macarthur Health Service patient safety breaches. All data was publicly available and assessed according to the requirements of unobtrusive research methods and secondary data analysis. Ethical considerations: Data collection for the case studies relied entirely on publicly available documentary sources recounting and detailing past events. Findings: Data from both cases reveal managers demonstrating wilful blindness towards patient safety concerns. Concerns were unaddressed; nurses, instead, experienced retaliatory responses leading to a 'social crisis' in the organisation and to whistleblowing. Conclusion: Managers tasked with clinical governance must be aware of mechanisms with the potential to blind them. The human tendency to favour positive news and avoid conflict is powerful. Understanding wilful blindness can assist managers' awareness of the competing emotions occurring in response to ethical challenges, such as whistleblowing.
机译：背景：在他们试图在内部解决患者的安全问题后，通过故意的盲人管理人员忽略了内部，来自Bundaberg基地医院和麦克阿瑟保健服务的护士被迫“吹口哨”。故意失明是人类愿意渴望知识无知;被告知的责任被搁置。目的：在澳大利亚的两个高调举行的护士举行案件中确定了故意失明的情况。研究设计：批判性案例研究方法使用Fay关键社会理论研究，分析和解释委员会委员会委员会委员会委员会委员会委员会委员会生成的现有数据和麦克阿瑟卫生服务患者安全漏洞。所有数据都公开可用并根据不引人注目的研究方法和二级数据分析的要求进行评估。道德考虑因素：案例研究的数据收集完全依赖于公开的纪录片来源，提出并详细说明过去的事件。调查结果：两种情况的数据都显示经理展示了对患者安全问题的故意失明。担心未解决;相反，护士经历了恢复性反应，导致组织中的“社会危机”和举报人。结论：应有临床治理的经理必须意识到有可能盲目的机制。人类倾向于有利于积极新闻，避免冲突是强大的。了解故意失明可以协助管理者对响应伦理挑战而发生的竞争情绪的认识，例如举报人。

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