Nodabase.net

Tvangsprotokollene

Description

Health care professionals are required to record every incident of coercive restraint every time a patient is tied down. The employee in charge is required to explain why restraints were needed and how long the patient had to be restrained.

After a fighting for six months to get access to these logbooks through public information laws, VG digitized several thousand handwritten notes with the purpose of analysing the extent and use of coercion at psychiatric institutions in Norway.

Several of Norway’s leading legal experts and law professors in the field of coercion in psychiatric health care reviewed the justifications and concluded that the material exposed extensive statutory violations, questionable justifications for why restraints were used and serious discrepancies in how psychiatric wards and hospitals put coercion into practice. VG also revealed how the State control agencies that are tasked with ensuring patient rights, failed to do their job.

Origin

The origin of VG’s investigation was a story we published in March 2016 about a young woman who petitioned the court to release her from a psychiatric hospital so she could take her own life. VG’s journalists stayed in contact with the woman, learning that she had spent the majority of the last two years tied down in a bed at a psychiatric hospital in Oslo.

By investigating the difficult ethical issues in her case, the journalists wanted to figure out just how unique her story was. How often are patients being tied down and for how long?

VG contacted 102 institutions that are authorized to use coercion in April 2016. VG found that the hospitals failed to report about 1 out of 4 incidents of restraint. St Olav’s Hospital in Trondheim and the Møre og Romsdal Hospital Trust, among others, failed to report 80% of all incidents where belts were used to restrain patients.

Data

We learned that hospitals are required to keep handwritten notes for each incident of coercion. The procedure has not changed in 170 years.

Information from patient journals are normally exempt from public disclosure, and many hospitals refused to hand the logbooks over, but VG fought for the right to review those records – and after three rounds of complaints with the national health authorities VG finally won; we were given copies of several thousand pages of information.

We digitized the logbooks and devised an analytics tool where the information could be divided into graphics and diagrams that show the times of year, weeks and days on which patients were tied down.

The final material contains the full coercion logs from 2015 for 14 psychiatric institutions, documenting 2538 incidents of coercion use against 996 patients. 640 incidents were considered unlawful or problematic by legal experts.

Resources

Effectively two journalists for two months to do the digitization, with help from one data scientist and one editorial developer to structure the dataset, analysis and tools development.

Impact

VG’s publications led to several national and regional investigations into how hospitals could reduce the use of coercion. All hospitals were ordered to review their previous coercion statistics and told to report accurate figures this time. There are plans to introduce a new registration system starting in 2017.

The Parliamentary Ombudsman, the Minister of Health and legal experts said VG’s journalistic efforts brought great concern for the rights of the weakest patient groups in our society.

The Minister of Health announced that he would like to reorganize the entire Control Commission system. There will be made modifications to their tasks in short term, and a full reorganization or shutdown in the longer term.

The Chief County Medical Officer for Oslo and Akershus Counties initiated two regulatory investigations based on VG’s findings, and many families talk about bringing their cases to the courts after learning the rights of their family members may have been violated.

Obstacles

1. Getting the data

While some institutions immediately understood the importance of being transparent about how they used physical coercion, some institutions systematically tried to undermine the release of the coercion logs and fought for several months to keep them secret. It took around half a year – and three complaints to the Ministry of Health – to establish that the logs should be made public under Norway’s freedom of information laws.

2. Manual work to digitize handwritten copies

Hard-to-read copies of the handwritten logs made OCR or automated digitization out of the question. The logs (around 10,000 rows of data) were manually digitized, cleaned, tagged to make analysis and publication of the database possible.

Go to case website
Built on WordPress by Smart Media AS

Privacy Policy

The Privacy Statement is about how this website collects and uses visitor information. The statement contains information that you are entitled to when collecting information from our website (Personal Information Act, section 19), and general information about how we treat personal data (Personal Data Act, section 18, first paragraph). The legal owner of the website is the processing officer for the processing of personal data. It is voluntary for those who visit the web sites to provide personal information regarding services such as receiving newsletters and using the sharing and tip services. The treatment basis is the consent of the individual, unless otherwise specified.

1. Web analytics and cookies (cookies)

As an important part of the effort to create a user-friendly website, we look at the user pattern of those who visit the site. To analyze the information, we use the Google Analytics analysis tool. Google Analytics uses cookies (small text files that the site stores on the user's computer), which registers the users' IP address and provides information about the individual user's online movements. Examples of what the statistics give us answers to are; how many people visit different pages, how long the visit lasts, what websites users come from and what browsers are used. None of the cookies allow us to link information about your use of the site to you as an individual. The information collected by Google Analytics is stored on Google servers in the U.S.. The information received is subject to the Google Privacy Policy. An IP address is defined as a personal information because it can be traced back to a particular hardware and thus to an individual. We use Google Analytics's tracking code to anonymize the IP address before the information is stored and processed by Google. Thus, the stored IP address can not be used to identify the individual user.

2. Search

If the webpage has search function, it stores information about what keywords users use in Google Analytics. The purpose of the storage is to improve our information service. The search usage pattern is stored in aggregate form. Only the keyword is saved and they can not be linked to other information about the users, such as the IP addresses.

3. Share / Tips service

The "Share with others" feature can be used to forward links to the site by email, or to share the content of social networking. Tips for tips are not logged with us, but only used to add the tips to the community. However, we can not guarantee that the online community does not log this information. All such services should therefore be used wisely. If you use the email feature, we only use the provided email addresses to resend the message without any form of storage.

4. Newsletter

The website can send out newsletters by email if you have registered to receive this. In order for us to be able to send e-mail, you must register an e-mail address. Mailchimp is the data processor for the newsletter. The e-mail address is stored in a separate database, not shared with others and deleted when you unsubscribe. The e-mail address will also be deleted if we receive feedback that it is not active.

5. Registration, form

The website may have a form for registration, contact form or other form. These forms are available to the public to perform the tasks they are supposed to do. Registration form is for visitors to sign up or register. Contact form is for visitors to easily send a message to the website's contact person. We ask for the name of the sender and contact information for this. Personal information we receive is not used for purposes other than responding to the inquiry. The form is sent as email via Mailgun as a third party solution. The entire submission will be stored at Mailgun for 24 hours. Between 24 hours and 30 days, only mailheader is stored before the submission is deleted after 30 days. The reason for this storage is to confirm whether emails are sent from the website and forwarded to the correct recipient. Once the email is received by the recipient, it is up to the recipient to determine the data processing needs of the email.

6. Page and service functionality

Cookies are used in the operation and presentation of data from websites. Such cookies may contain language code information for languages ​​selected by the user. There may be cookies with information supporting the load balancing of the system, ensuring all users the best possible experience. For services that require login or search, cookies can be used to ensure that the service presents data to the right recipient.

7. How to manage cookies in your browser

On www.nettvett.no, read how to configure your browser to accept / reject cookies, and get tips for safer use of the internet.