Karissa M Fenwick1, Karen E Dyer2, Ruth Klap2, Kristina Oishi2, Jessica L Moreau2, Elizabeth M Yano2,3,4, Bevanne Bean-Mayberry2,4, Anne G Sadler5,6, Alison B Hamilton2,7. 1. HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. Karissa.Fenwick@va.gov. 2. HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. 3. Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA. 4. Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. 5. VA Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, USA. 6. Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA. 7. Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA, USA.
Abstract
BACKGROUND: Patient-perpetrated sexual harassment toward staff and patients is prevalent in Veterans Affairs and other healthcare settings. However, many healthcare facilities do not have adequate systems for reporting patient-perpetrated harassment, and there is limited evidence to guide administrators in developing them. OBJECTIVE: To identify expert recommendations for designing effective systems for reporting patient-perpetrated sexual harassment of staff and patients in Veterans Affairs and other healthcare settings. DESIGN: We conducted qualitative interviews with subject matter experts in sexual harassment prevention and intervention during 2019. PARTICIPANTS: We used snowball sampling to recruit subject matter experts. Participants included researchers, clinicians, and administrators from Veterans Affairs/other healthcare, academic, military, and non-profit settings (n = 33). APPROACH: We interviewed participants via telephone using a semi-structured guide and analyzed interview data using a constant comparative approach. KEY RESULTS: Expert recommendations for designing reporting systems to address patient-perpetrated sexual harassment focused on fostering trust, encouraging reporting, and deterring harassment. Recommendations included the following: (1) promote a climate in which harassment is not tolerated; (2) take proportional, corrective actions in response to reports; (3) minimize adverse outcomes for reporting parties; (4) facilitate and simplify reporting processes; and (5) hold the reporting system accountable. Specific strategies related to each recommendation were also identified. CONCLUSIONS: This qualitative study generated initial recommendations to guide healthcare administrators and policy makers in assessing, developing, and improving systems for reporting patient-perpetrated sexual harassment toward staff and other patients. Results indicate that proactive, careful design and ongoing evaluation are essential for ensuring that reporting systems have their intended effects and mitigating the risks of inadequate systems. Additional research is needed to evaluate strategies that effectively address patient-perpetrated harassment while balancing patients' clinical needs.
BACKGROUND: Patient-perpetrated sexual harassment toward staff and patients is prevalent in Veterans Affairs and other healthcare settings. However, many healthcare facilities do not have adequate systems for reporting patient-perpetrated harassment, and there is limited evidence to guide administrators in developing them. OBJECTIVE: To identify expert recommendations for designing effective systems for reporting patient-perpetrated sexual harassment of staff and patients in Veterans Affairs and other healthcare settings. DESIGN: We conducted qualitative interviews with subject matter experts in sexual harassment prevention and intervention during 2019. PARTICIPANTS: We used snowball sampling to recruit subject matter experts. Participants included researchers, clinicians, and administrators from Veterans Affairs/other healthcare, academic, military, and non-profit settings (n = 33). APPROACH: We interviewed participants via telephone using a semi-structured guide and analyzed interview data using a constant comparative approach. KEY RESULTS: Expert recommendations for designing reporting systems to address patient-perpetrated sexual harassment focused on fostering trust, encouraging reporting, and deterring harassment. Recommendations included the following: (1) promote a climate in which harassment is not tolerated; (2) take proportional, corrective actions in response to reports; (3) minimize adverse outcomes for reporting parties; (4) facilitate and simplify reporting processes; and (5) hold the reporting system accountable. Specific strategies related to each recommendation were also identified. CONCLUSIONS: This qualitative study generated initial recommendations to guide healthcare administrators and policy makers in assessing, developing, and improving systems for reporting patient-perpetrated sexual harassment toward staff and other patients. Results indicate that proactive, careful design and ongoing evaluation are essential for ensuring that reporting systems have their intended effects and mitigating the risks of inadequate systems. Additional research is needed to evaluate strategies that effectively address patient-perpetrated harassment while balancing patients' clinical needs.
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